Individual provider Active NPI

Robert Goble, D.D.S.

  • Dentist
  • Bellefontaine, OH
National Provider Identifier
1477577476
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
18507 Issued in OH
Practice address
139 W Sandusky Ave
Bellefontaine, OH 43311-1415
Phone
(937) 592-5941
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 18507 OH Primary

Addresses

Primary practice location

139 W Sandusky Ave
Bellefontaine, OH 43311-1415

Mailing address

139 W Sandusky Ave
Bellefontaine, OH 43311-1415
Phone (937) 592-5941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160208002082 OH Practitioner - Oral Surgery 0042514291 Practice locations: Bellefontaine, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18507OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477577476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 W SANDUSKY AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433111415",
            "telephone_number": "937-592-5941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 W SANDUSKY AVE",
            "city": "BELLEFONTAINE",
            "state": "OH",
            "postal_code": "433111415",
            "telephone_number": "937-592-5941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOBLE",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "18507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellefontaine, OH

Sources for this page

Verify at the official NPI Registry.