Michael Timothy Gocke, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

0401411538 Issued in VA

Practice address

7601 Lewinsville Rd
Suite 203
McLean, VA 22102-2814

Phone

(703) 388-2805

Fax

(703) 388-2806

NPI assigned

Apr 2, 2007

Last updated

Dec 12, 2016By 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 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 23, 2015 through Jun 23, 2027

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.

• Viriginia Oral Facial & Implant Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • McLean, VA
  • NPI 1588867113
  NPD (past) Authorized official
• Reston Oral and Facial Surgery PLLC

  dba Virginia Advanced Surgical Arts

  • Oral and Maxillofacial Surgery Clinic/Center
  • Reston, VA
  • NPI 1639919194
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1336260843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645205",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152645205",
            "telephone_number": "866-756-3200",
            "fax_number": "479-725-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 LEWINSVILLE RD",
            "address_2": "SUITE 203",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221022814",
            "telephone_number": "703-388-2805",
            "fax_number": "703-388-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCKE",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401411538",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "3585",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "VA",
            "license": "0401411538",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WV",
            "license": "3585",
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "VA",
            "license": "0401411538",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9200594",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyce Girardi, MD
• David A Glaser, LCSW
• Susan F. Glaser, PH.D.
• Gloria Duda, M.D., P.C.
• Anne G Glynn, PTA
• Kristine Leuvelink Goddard, MASSAGE THERAPIST
• Emily Blair Goff, M. ED, LPC
• Janis W. Gold, LPC, LMFT
• Azadeh Pajoohesh Goldberg
• Fred Elias Goldberg, O.D.

• Oral and Maxillofacial Surgery (Dentist) in McLean, VA
• Providers in McLean, VA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.