Active NPI
Daniel Gomes, DDS, MSD
- Periodontics
- Indianapolis, IN
National Provider Identifier
1942358007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12010704-A
- Practice address
- 8235 Country Village Dr
Indianapolis, IN 46214 - Phone
- (317) 299-4731
- Fax
- (317) 329-5054
- NPI assigned
- Jan 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12010704-A | IN | Primary |
Addresses
Primary practice location
8235 Country Village Dr
Indianapolis, IN 46214
Mailing address
8235 Country Village Dr
Indianapolis, IN 46214
Phone (317) 299-4731
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12010704-A | IN | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493596800000",
"number": "1942358007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8235 COUNTRY VILLAGE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46214",
"telephone_number": "317-299-4731",
"fax_number": "317-329-5054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8235 COUNTRY VILLAGE DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "46214",
"telephone_number": "317-299-4731",
"fax_number": "317-329-5054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMES",
"first_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2017-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IN",
"license": "12010704-A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.