Jossen P Gastelum, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010862 Issued in AZ

Practice address

12090 N Thornydale Rd Ste 106
Marana, AZ 85658-4779

Phone

(520) 616-4610

NPI assigned

Jul 29, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• THG Dental, PLLC

  • General Practice Dentistry
  • Marana, AZ
  • NPI 1669636189
  NPD (past)
• Abshier Dental Care, PLLC, Wil M. Abshier, Jr., D.M.D.

  • Dental Clinic/Center
  • Pewee Valley, KY
  • NPI 1538397989
  NPD (past)

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604102400000",
    "number": "1730798331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12090 N THORNYDALE RD STE 106",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856584779",
            "telephone_number": "520-616-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12090 N THORNYDALE RD STE 106",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856584779",
            "telephone_number": "520-616-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTELUM",
        "first_name": "JOSSEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-10-31",
        "certification_date": "2020-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10479",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Folarin Healthcare LLC
• Madalyn Gene Fruge
• Elizabeth Gapp, M.S.
• Susan A. Garcia, M.S., CCC-SLP
• Keri Gardner, RN
• Joshua Gibbel, FNP
• Gladden Farms Chiropractic PLLC
• Lauri Wyrick Glasshoff, M.S., CCC-SLP
• Zandra Goldstein
• Good Health Medical, PLLC

• General Practice Dentistry in Marana, AZ
• Providers in Marana, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2020; 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.