Michael Joseph Gaughan, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS024685L Issued in PA

Practice address

255 S 17TH St
Suite 1309
Philadelphia, PA 19103-6231

Phone

(215) 735-2915

Fax

(215) 735-5105

NPI assigned

Dec 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669534392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "address_2": "SUITE 1309",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "215-735-2915",
            "fax_number": "215-735-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "address_2": "SUITE 1309",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "215-735-2915",
            "fax_number": "215-735-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUGHAN",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024685L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santino Gaudino
• Eva Rose Gaufberg
• Abby Trenaman Gaughan, D.M.D.
• Kaila Gaughan, PA-C
• Megan Gaughan
• William J Gaughan, MD
• Brianna Mary Gaul, PA-C
• Elise Gaul, MS, LPC, CT
• Jessica Gaulin, LBS
• Ashley Taylor Gault, DO

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.