NPIMap

Organization Active NPI

J. Chris Gorham PA

  • General Practice Dentistry
  • Round Rock, TX
National Provider Identifier
1700930708
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20097 Issued in TX
Legal business name
J. CHRIS GORHAM PA
Practice address
2000 S I H 35 Ste K1
Round Rock, TX 78681-6916
Phone
(512) 255-7839
Fax
(512) 255-7898
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Authorized official

Name
Dr. J. Chris Gorham, D.D.S.
Title
Owner
Phone
(512) 255-7839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 20097 TX Primary

Addresses

Primary practice location

2000 S I H 35 Ste K1
Round Rock, TX 78681-6916

Mailing address

2000 S I H 35 Ste K1
Round Rock, TX 78681-6916
Phone (512) 255-7839

Other identifiers 2

IdentifierTypeStateIssuer
89D255OtherTXBLUE CROSS BLUE SHIELD OF TEXAS
89D254OtherTXBLUE CROSS BLUE SHIELD OF TEXAS

Other names 1

  • Round Rock Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

2000 S Interstate 35
Ste K1
Round Rock, TX 78681
Phone (512) 255-7839

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1700930708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S I H 35 STE K1",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786816916",
            "telephone_number": "512-255-7839",
            "fax_number": "512-255-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S I H 35 STE K1",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786816916",
            "telephone_number": "512-255-7839",
            "fax_number": "512-255-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. CHRIS GORHAM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "GORHAM",
        "authorized_official_first_name": "J. CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-255-7839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "89D255",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "89D254",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Round Rock Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.