Mikhail Gomer, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21083 Issued in MA

Practice address

525 South Broadway
Lawrence, MA 01843

Phone

(978) 682-0641

Fax

(978) 682-0644

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1649289802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 SOUTH BROADWAY",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01843",
            "telephone_number": "978-682-0641",
            "fax_number": "978-682-0644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 SOUTH BROADWAY",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "01843",
            "telephone_number": "978-682-0641",
            "fax_number": "978-682-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMER",
        "first_name": "MIKHAIL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "21083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0203131",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glorious Home Care Inc
• Robert Godefroi, M.D.
• Belen Emilia Godwin, MSW
• James Lee Goldfinch, PH.D.
• Richard A. Goldman, M.D.
• Svetlana Gomer, DMD
• Thomas Michael Gomes II, MD
• Maria Del Carmen Gomez Goris
• Ashley Rosmeri Gomez
• Jissel Altagracia Gomez

• General Practice Dentistry in Lawrence, MA
• Providers in Lawrence, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.