Charles Connally Gaines, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

TX 12565 Issued in TX

Practice address

5616 SW Green Oaks Blvd Ste 1
Arlington, TX 76017-1159

Phone

(817) 572-3351

Fax

(817) 561-4223

NPI assigned

May 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811108350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 SW GREEN OAKS BLVD STE 1",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171159",
            "telephone_number": "817-572-3351",
            "fax_number": "817-561-4223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 SW GREEN OAKS BLVD STE 1",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171159",
            "telephone_number": "817-572-3351",
            "fax_number": "817-561-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "CHARLES",
        "middle_name": "CONNALLY",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "TX 12565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abdulaziz Gafar
• Jamie Gaffney
• Danielle Gage
• Denise A Gage, MA, CCC, LSLS, CERT
• Sareena Lani Gahunia, M.D.
• Jalayna Dickerson Gaines, LCSW
• Lani Gaines
• Tiffani Rolanna Gaines, M.S. IN PSYCHOLOGY
• Kishan Bharat Gajera
• Anoop Singh Gala

• General Practice Dentistry in Arlington, TX
• Providers in Arlington, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.