Individual provider Active NPI

Gary Dee Goaslind, D.D.S., M.S.

  • Periodontics
  • Las Vegas, NV
National Provider Identifier
1457512923
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2635/S4-13 Issued in NV
Practice address
3811 W Charleston Blvd
#201
Las Vegas, NV 89102-1846
Phone
(702) 259-1943
Fax
(702) 877-2727
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2635/S4-13 NV Primary

Addresses

Primary practice location

3811 W Charleston Blvd
#201
Las Vegas, NV 89102-1846

Mailing address

3811 W Charleston Blvd
#201
Las Vegas, NV 89102-1846
Phone (702) 259-1943

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20141016002563 NV Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476774449

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2635/S4-13NVMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Trylovich, Gifford, LTD. Periodontics 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1457512923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 W CHARLESTON BLVD",
            "address_2": "#201",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021846",
            "telephone_number": "702-259-1943",
            "fax_number": "702-877-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 W CHARLESTON BLVD",
            "address_2": "#201",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021846",
            "telephone_number": "702-259-1943",
            "fax_number": "702-877-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOASLIND",
        "first_name": "GARY",
        "middle_name": "DEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NV",
            "license": "2635/S4-13",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.