Individual provider Active NPI

Darryl Gurecky, D.D.S.

  • Dentist
  • Spokane, WA
National Provider Identifier
1528284643
Registry record updated May 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE00010837 Issued in WA
Practice address
9717 N Nevada St
Spokane, WA 99218-3412
Phone
(509) 467-3315
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 16501 TX
Dentist 122300000X DE00010837 WA Primary

Addresses

Primary practice location

9717 N Nevada St
Spokane, WA 99218-3412

Mailing address

9717 N Nevada St
Spokane, WA 99218-3412
Phone (509) 467-3315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150522001026 WA Order and Referring Only - DentistPractitioner - Dentist 8022338557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00010837WAMDDentist
16501TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1528284643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9717 N NEVADA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992183412",
            "telephone_number": "509-467-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9717 N NEVADA ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992183412",
            "telephone_number": "509-467-3315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURECKY",
        "first_name": "DARRYL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "16501",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.