Tracey L Gaston, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

9901 S Western Ave Ste 209
Chicago, IL 60643-1800

Phone

(773) 233-1710

Fax

(773) 233-1704

NPI assigned

Oct 25, 2007

Last updated

Oct 25, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Tracey L Gaston Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1770762866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 S WESTERN AVE STE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431800",
            "telephone_number": "773-233-1710",
            "fax_number": "773-233-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 S WESTERN AVE STE 209",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431800",
            "telephone_number": "773-233-1710",
            "fax_number": "773-233-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASTON",
        "first_name": "TRACEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "GASTON",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dragan Gastevski, MD
• Darrien Lance Gaston, M.D.
• Gina Blanche Gaston, MSW, PHD, LCSW
• Ian Gaston
• Jocelyn Gaston
• Gastroenterology Associates SC
• Gastroenterology Solutions, S.C.
• Jae Gatchalian
• Brittany Lauren Gatchell, LCSW
• Abbey Storey Gately, CRC, LCPC

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.