Individual provider Active NPI

Julie A Gaskill, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Bowling Green, KY
National Provider Identifier
1790895910
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6532 Issued in KY
Practice address
546 Park St
Suite 500
Bowling Green, KY 42101
Phone
(270) 843-6891
Fax
(270) 843-4469
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6532 KY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6532 KY Primary

Addresses

Primary practice location

546 Park St
Suite 500
Bowling Green, KY 42101

Mailing address

546 Park St
Suite 500
Bowling Green, KY 42101
Phone (270) 843-6891

Other identifiers 3

IdentifierTypeStateIssuer
64065329MedicaidKY
000000069019OtherKYANTHEM
60065323OtherKYMEDICAID DENTAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090914000795 KY Practitioner - Maxillofacial Surgery 3678629755 Practice locations: Bowling Green, KY

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1844 Lyda Ave
Bowling Green, KY 42104-3361
Phone (270) 843-6891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6532KYMDSocial Worker
00000KYMDGenetic Counselor (M.S.)

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1790895910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 PARK ST",
            "address_2": "SUITE 500",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42101",
            "telephone_number": "270-843-6891",
            "fax_number": "270-843-4469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PARK ST",
            "address_2": "SUITE 500",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42101",
            "telephone_number": "270-843-6891",
            "fax_number": "270-843-4469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GASKILL",
        "first_name": "JULIE",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "6532",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "6532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64065329",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000069019",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DENTAL",
            "identifier": "60065323",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.