Gary Alan Gorrell, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

56699 Issued in CA

Practice address

29273 Central Ave
Suite a
Lake Elsinore, CA 92532-2254

Phone

(951) 245-8664

NPI assigned

Dec 12, 2007

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 CA

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 and National Provider Directory roles.

• Watanabe and Lynn Dental Corporation

  dba Marketplace Dental Group

  • General Practice Dentistry
  • Lake Elsinore, CA
  • NPI 1396830790
  NPD (past)

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201910400000",
    "number": "1386827426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29273 CENTRAL AVE",
            "address_2": "SUITE A",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322254",
            "telephone_number": "951-245-8664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29273 CENTRAL AVE",
            "address_2": "SUITE A",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925322254",
            "telephone_number": "951-245-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORRELL",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2008-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hugo A Gonzalez, MD
• Johanna Gonzalez
• Sierra Grace Gonzalez
• Good Shepherd Counseling Clinic
• Alajah Goodman
• Gowda Professional Dental Inc (Lakeshore Family Dentistry)
• James Morriss Grady II
• Giselle Grajeda
• Grand Terrace Detox and Recovery
• Philip Grande, LMFT

• Dentist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2008; 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.