Active NPI
Jeffery Lee Gore, D.D.S.
- Dentist
- Richmond, IN
National Provider Identifier
1376575928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12009353
- Practice address
- 1927 National Rd W
Richmond, IN 47374-3851 - Phone
- (765) 966-1398
- Fax
- (765) 966-2380
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12009353 | IN | Primary |
Addresses
Primary practice location
1927 National Rd W
Richmond, IN 47374-3851
Mailing address
1927 National Rd W
Richmond, IN 47374-3851
Phone (765) 966-1398
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12009353 | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376575928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1927 NATIONAL RD W",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473743851",
"telephone_number": "765-966-1398",
"fax_number": "765-966-2380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1927 NATIONAL RD W",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473743851",
"telephone_number": "765-966-1398",
"fax_number": "765-966-2380"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORE",
"first_name": "JEFFERY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12009353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.