Jeffrey S. Forgosh, D.MD., P.a.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

NH 1405 Issued in NH

Legal business name

JEFFREY S. FORGOSH, D.MD., P.A.

Practice address

280 Pleasant St
Concord, NH 03301-2553

Phone

(603) 228-1191

Fax

(603) 228-1317

NPI assigned

Aug 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Stephen Forgosh, D.M.D.

Title

Owner/Practitioner

Phone

(603) 228-1191

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902919079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012553",
            "telephone_number": "603-228-1191",
            "fax_number": "603-228-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012553",
            "telephone_number": "603-228-1191",
            "fax_number": "603-228-1317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY S. FORGOSH, D.MD., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORGOSH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "603-228-1191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NH",
            "license": "NH 1405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30300793",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Concord, NH
• Providers in Concord, NH by specialty
• Periodontics in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.