Michael B Gasko,DDS ,Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007239IN Issued in IN

Legal business name

MICHAEL B GASKO,DDS ,INC

Practice address

225 N Notre Dame Ave
5
South Bend, IN 46617-2839

Phone

(574) 234-6561

Fax

(574) 286-5144

NPI assigned

Aug 20, 2015

Last updated

Aug 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael B Gasko, DDSNPI 1407921927

Title

President

Phone

(574) 234-6561

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Bernard Gasko, D.D.S.

  • General Practice Dentistry
  • Mishawaka, IN
  • NPI 1407921927
  NPD (past) Authorized official

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1538535836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N NOTRE DAME AVE",
            "address_2": "5",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172839",
            "telephone_number": "574-234-6561",
            "fax_number": "574-286-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N NOTRE DAME AVE",
            "address_2": "5",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172839",
            "telephone_number": "574-234-6561",
            "fax_number": "574-286-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL B GASKO,DDS ,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "GASKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-234-6561",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007239IN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200106530A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.