Individual provider Active NPI

Gary L Pool, D.M.D. ,M.S. ,P.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Warner Robins, GA
National Provider Identifier
1730253717
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
010236 Issued in GA
Practice address
1721 Russell Pkwy
Warner Robins, GA 31088-5707
Phone
(478) 328-7049
Fax
(478) 328-6351
NPI assigned
Nov 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 010236 GA Primary

Addresses

Primary practice location

1721 Russell Pkwy
Warner Robins, GA 31088-5707

Mailing address

1721 Russell Pkwy
Warner Robins, GA 31088-5707
Phone (478) 328-7049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
010236GAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730253717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 RUSSELL PKWY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885707",
            "telephone_number": "478-328-7049",
            "fax_number": "478-328-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 RUSSELL PKWY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885707",
            "telephone_number": "478-328-7049",
            "fax_number": "478-328-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOL",
        "first_name": "GARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D. ,M.S. ,P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "010236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • 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.