Individual provider Active NPI

Christopher S Gatehouse, DMD

  • Dentist
  • Clinton, CT
National Provider Identifier
1891082616
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
010728 Issued in CT
Practice address
145R E Main St
Clinton, CT 06413-2104
Phone
(860) 669-2700
Fax
(860) 669-7585
NPI assigned
Jun 30, 2011
Last updated
Oct 9, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 010728 CT Primary

Addresses

Primary practice location

145R E Main St
Clinton, CT 06413-2104

Mailing address

145R E Main St
Clinton, CT 06413-2104
Phone (860) 669-2700

Other identifiers 1

IdentifierTypeStateIssuer
004011136MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20150618001815 CT Order and Referring Only - DentistPractitioner - Dentist 4385955277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010728CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Connecticut Dental Professionals, P.C. Past Accepting new patients
Clinton Family Dentistry, LLC Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1891082616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145R E MAIN ST",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132104",
            "telephone_number": "860-669-2700",
            "fax_number": "860-669-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145R E MAIN ST",
            "city": "CLINTON",
            "state": "CT",
            "postal_code": "064132104",
            "telephone_number": "860-669-2700",
            "fax_number": "860-669-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATEHOUSE",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "010728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004011136",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, CT

Sources for this page

Verify at the official NPI Registry.