Richard Gelder, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7702 Issued in FL

Practice address

19240 Quesada Ave
Port Charlotte, FL 33948-3126

Phone

(941) 743-7435

Fax

(941) 743-7429

NPI assigned

Feb 23, 2007

Last updated

Sep 8, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Panther Hollow Dental Lodge, PL

  • General Practice Dentistry
  • Port Charlotte, FL
  • NPI 1265671887
  NPD (past)
• Panther Hollow Family Dental PA

  dba Panther Hollow Dental Lodge

  • General Practice Dentistry
  • Port Charlotte, FL
  • NPI 1104491877
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1285769794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19240 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483126",
            "telephone_number": "941-743-7435",
            "fax_number": "941-743-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19240 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483126",
            "telephone_number": "941-743-7435",
            "fax_number": "941-743-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELDER",
        "first_name": "RICHARD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "7702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.