Kelly Eugene Gilmore, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9901 Issued in OR

Practice address

762 High St NE
Salem, OR 97301-2440

Phone

(503) 364-7502

Fax

(503) 364-1254

NPI assigned

Sep 13, 2013

Last updated

Sep 13, 2013By 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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Gilmore Family Dentistry PC

  • General Practice Dentistry
  • Salem, OR
  • NPI 1942710058
  NPD (past) Authorized official

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1326473901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 HIGH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012440",
            "telephone_number": "503-364-7502",
            "fax_number": "503-364-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 HIGH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012440",
            "telephone_number": "503-364-7502",
            "fax_number": "503-364-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KELLY",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Gilliard
• Rachel Gilliland, CADC II, QMHP
• Erik Stephen Gillis, PA-C MHS
• Tysandra Gillis, LMT
• Gilmore Family Dentistry PC
• Tyler Gilmore
• Vernon Gibson Gilmore, D.M.D.
• Shannon Gima, QMHA
• Claudia S Gimenez, M.A.
• Yekaterina Gincherman, M.D.

• General Practice Dentistry in Salem, OR
• Providers in Salem, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.