Candace Faith Gershkovich, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D008704 Issued in AZ

Practice address

4235 W. Thunderbird Rd
Phoenix, AZ 85053

Phone

(215) 914-2157

Fax

(215) 914-2177

NPI assigned

Jul 8, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Az Premier House Call Dentistry PLLC

  • Dental Clinic/Center
  • Phoenix, AZ
  • NPI 1447951561
  NPD

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1437446580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11402 N CAVE CREEK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85020",
            "telephone_number": "480-577-1958",
            "fax_number": "215-914-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4235 W. THUNDERBIRD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85053",
            "telephone_number": "215-914-2157",
            "fax_number": "215-914-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERSHKOVICH",
        "first_name": "CANDACE",
        "middle_name": "FAITH",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038758",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Geronimo, DDS
• Geropsych Management, LLC
• Geropsychmd LLC
• Anthony John Geroulis, DDS
• Cory Gersh, PT
• Joanne Gerster
• Mariana Sylvia Gertz, MS CCC
• Jacob Scott Gervais, PA-C
• Robert Paul Gervais, M.D.
• Christian Gerwe, MD

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; 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.