GARY L. GOTSCH DDS, MSD, LLC (NPI# 1336502145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336502145 |
| Entity Type | Organization |
| Organization Name | GARY L. GOTSCH DDS, MSD, LLC |
| Practice Address |
4205 Hobson Ct Fort Wayne IN 46815-8648 |
| Practice Telephone | 2604868788 |
| Practice Fax Number | 2604867679 |
| Mailing Telephone | 2604868778 |
| Mailing Fax Number | 2604867679 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-10-10 |
| Authorized Official Name | DR. GARY L GOTSCH (OWNER/DENTIST) |
| Authorized Official Telephone | 2604868778 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 7341 | IN | Suppliers |
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers |
| Street Address |
4205 HOBSON CT |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46815-8648 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174627749 | Gary Lynn Gotsch | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2006-09-12 |
| 1447713219 | Fort Wayne Prosthodontics, Inc. | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2019-04-09 |
| 1467773911 | Ryan Dean Zimmerman | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2010-06-18 |
| 1578732020 | Gary L. Gotsch Dds Msd | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2008-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306305438 | Sullivan Services, Inc. | In Home Supportive Care | 2789-b Maplecrest Rd, Fort Wayne, IN 46815 | 2019-03-18 |
| 1598250144 | Altermease Gleason | Massage Therapist | 3406 Thames Drive, Fort Wayne, IN 46815 | 2018-06-26 |
| 1881000222 | Denise Sparks | Specialist | 6415 Benham Drive, Fort Wayne, IN 46815 | 2014-07-07 |
| 1962823138 | Chad Distelrath | Physical Therapy Assistant | 1717 Maplecrest Rd, Apt 112, Fort Wayne, IN 46815 | 2013-12-13 |
| 1689943409 | Kendall Joan Labrash | Physical Therapist | 4251 Lahmeyer Rd., Fort Wayne, IN 46815 | 2011-12-22 |
| 1801179718 | Jayson Laube | Pharmacist | 6201 Stellhorn, Fort Wayne, IN 46815 | 2011-09-27 |
| 1720294432 | Muscle Therapy Clinic LLC | Massage Therapist | 6409 Georgetown North Blvd, Fort Wayne, IN 46815 | 2007-05-16 |
| 1427186436 | Legoras Conture Fashions | Prosthetic/Orthotic Supplier | 3316 Inwood Drive, Fort Wayne, IN 46815 | 2007-03-01 |
| 1932252772 | Fort Wayne Smiles PC | Dentist | 2031 Reed Road, Fort Wayne, IN 46815 | 2007-01-18 |
| 1811078538 | Timothy Doody Lynch | Dentist | 4207 Hobson Court, Fort Wayne, IN 46815 | 2006-10-18 |
| Find all providers in zip 46815 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174627749 | Gary Lynn Gotsch | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2006-09-12 |
| 1447713219 | Fort Wayne Prosthodontics, Inc. | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2019-04-09 |
| 1578732020 | Gary L. Gotsch Dds Msd | Dentist | 4205 Hobson Ct, Fort Wayne, IN 46815-8648 | 2008-02-28 |
| 1841317518 | Robert Louis Ketcham | Dentist | 1120 E Dupont Rd, Fort Wayne, IN 46825-1556 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780208884 | Prosthodontics of Central Indiana | Dentist | 11405 N Penn St Ste 110, Carmel, IN 46032-6905 | 2020-06-04 |
| 1962068502 | Karina Pezo Shirley | Dentist | 2001 W Washington St Ste B2, Indianapolis, IN 46222-4549 | 2019-05-18 |
| 1275039497 | Julianne Manzo Sotomil | Dentist | 1121 W Michigan St # S312, Indianapolis, IN 46202-5211 | 2018-04-05 |
| 1447638648 | Kamolphob Phasuk | Dentist | 1121 W Michigan St Rm 313, Indianapolis, IN 46202-5521 | 2015-05-08 |
| 1750799565 | Alexandra Polus | Dentist | 1549 S Court St Ste B, Crown Point, IN 46307-4809 | 2014-07-24 |
| 1073929832 | Tyler Jeffrey Thomas | Dentist | 370 Medical Dr Ste B, Carmel, IN 46032-2971 | 2014-07-01 |
| 1770994238 | Ankit Patel | Dentist | 5770 Noble Dr, Indianapolis, IN 46234-7725 | 2014-05-17 |
| 1902032030 | Kellie Michelle Schaub | Dentist | 370 Medical Dr., Ste B, Carmel, IN 46032 | 2009-06-03 |
| 1083852669 | Roland S. Outarsingh | Dentist | 548 Ridge Rd, Suite G, Munster, IN 46321-1649 | 2009-02-04 |
| 1609031335 | Michael Loren Drone | Dentist | 809 Wall St Ste B, Valparaiso, IN 46383-2571 | 2008-07-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46815 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.