Individual provider Active NPI

Robert Richard Gatehouse, DDS

  • Pediatric Dentistry
  • Middletown, CT
National Provider Identifier
1396736567
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
CT5145 Issued in CT
Practice address
828 Newfield St
Middletown, CT 06457-1857
Phone
(860) 613-0553
Fax
(860) 613-0206
NPI assigned
Nov 4, 2005
Last updated
Mar 31, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X CT5145 CT Primary

Addresses

Primary practice location

828 Newfield St
Middletown, CT 06457-1857

Mailing address

828 Newfield St
Middletown, CT 06457-1857
Phone (860) 613-0553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CT5145CTMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central CT. Pediatric Dentistry Pediatric Dentistry Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269993600000",
    "number": "1396736567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "828 NEWFIELD ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064571857",
            "telephone_number": "860-613-0553",
            "fax_number": "860-613-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 NEWFIELD ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064571857",
            "telephone_number": "860-613-0553",
            "fax_number": "860-613-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEHOUSE",
        "first_name": "ROBERT",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2010-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "CT5145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.