Keith David Gilmore, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS00004695 Issued in TN

Practice address

493 Henslee Dr
Dickson, TN 37055-2166

Phone

(615) 446-0106

Fax

(615) 446-1052

NPI assigned

Jun 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912936477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 HENSLEE DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552166",
            "telephone_number": "615-446-0106",
            "fax_number": "615-446-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 HENSLEE DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552166",
            "telephone_number": "615-446-0106",
            "fax_number": "615-446-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "KEITH",
        "middle_name": "DAVID",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS00004695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Brooke Fussell
• Nancy Futch
• Ciara Garcia Gentle, DPT
• Hailey Elizabeth Germanoski, MS, CF-SLP
• Cyrus Ghavam, MD
• Elsie Belle Givens, PT
• Bertha Ellen Glasgow
• Tonya Celeste Goforth, LPN
• Alexandria Goodwin
• Anna C Gorzny, DNP, APRN, FNP-BC

• General Practice Dentistry in Dickson, TN
• Providers in Dickson, TN by specialty
• General Practice Dentistry in Tennessee

• 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.