Richard Gore

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

CSDT-16 Issued in HI

Practice address

4800 Kawaihau Rd Ste D
Kapaa, HI 96746-1964

Phone

(808) 240-0180

Fax

(808) 822-9298

NPI assigned

Dec 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811059546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3990",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "96766",
            "telephone_number": "808-240-0100",
            "fax_number": "808-245-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 KAWAIHAU RD STE D",
            "city": "KAPAA",
            "state": "HI",
            "postal_code": "967461964",
            "telephone_number": "808-240-0180",
            "fax_number": "808-822-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "RICHARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "CSDT-16",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "523979-02",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA  EAST",
            "identifier": "0000258202",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HDS",
            "identifier": "CDST-16",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Wade Gatling, DPT
• Chauncey Giraldi, MSW
• Alana R. Goo-Frazier, NP-C
• Kaimana Mew Lung Goo-Rahtz, DMD, MPH
• Richard M. Goodale, M.D.
• Jere Mapuana Graham, APRN-BC RX
• Marquita Granda, MSN, FNP-C, PMHNP-BC
• Romeo Randon Guerpo Jr., DPT, PT
• Diane K Guidici, MFT, MIN.
• Amanda Michele Gutierrez, DPT

• General Practice Dentistry in Kapaa, HI
• Providers in Kapaa, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.