Individual provider Active NPI

Lukasz Artur Gorski, DDS

  • General Practice Dentistry
  • Santa Ana, CA
National Provider Identifier
1790933372
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56488 Issued in CA
Practice address
3620 S. Bristol Street
#207
Santa Ana, CA 92704
Phone
(714) 668-0558
Fax
(714) 979-3309
NPI assigned
Sep 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 56488 CA Primary

Addresses

Primary practice location

3620 S. Bristol Street
#207
Santa Ana, CA 92704

Mailing address

3620 S. Bristol Street
#207
Santa Ana, CA 92704
Phone (714) 668-0558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221121001395 CA Order and Referring Only - DentistPractitioner - Dentist 7618345778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1790933372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 S. BRISTOL STREET",
            "address_2": "#207",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-668-0558",
            "fax_number": "714-979-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 S. BRISTOL STREET",
            "address_2": "#207",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-668-0558",
            "fax_number": "714-979-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORSKI",
        "first_name": "LUKASZ",
        "middle_name": "ARTUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-08",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.