DR. DAVID LEE GASTON (NPI# 1851502033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851502033 |
| Entity Type | Individual |
| Full Name | DR. DAVID LEE GASTON |
| Credential | D.D.S. |
| Practice Address |
2634 Grand Ave Suite 204 Waukegan IL 60085-2458 |
| Practice Telephone | 8472490046 |
| Practice Fax Number | 8472491035 |
| Mailing Telephone | 8472490046 |
| Enumeration Date | 2007-05-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
019.018320 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790886067 | David A. Gaston | Massage Therapist | 6100 Blue Rock Rd, Cincinnati, OH 45247-2624 | 2006-09-26 |
| 1063899623 | David Curtis Gaston | Student in an Organized Health Care Education/Training Program | 20 York St, New Haven, CT 06510 | 2015-05-04 |
| 1811000227 | David Lee Gaston Jr. | Psychiatry & Neurology | 23077 Greenfield Rd, Suite 222, Southfield, MI 48075-3709 | 2006-08-17 |
| 1205818283 | David A Gaston II | Dermatology | 8333 N Davis Hwy, West Florida Medical Center Clinic Pa, Pensacola, FL 32514-6050 | 2005-11-16 |
| Street Address |
2634 GRAND AVE SUITE 204 |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60085-2458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144226762 | Joseph E Frydman | Ophthalmology | 2634 Grand Ave, Ste 201, Waukegan, IL 60085-2460 | 2005-06-28 |
| 1497085906 | Northwest Sleep Provider Inc. | Durable Medical Equipment & Medical Supplies | 2634 Grand Ave, Suite 107, Waukegan, IL 60085-2458 | 2010-01-05 |
| 1528220316 | Center for Neuro-diagnostic Testing, Inc. | Specialist/Technologist, Other | 2634 Grand Ave, Suite #101, Waukegan, IL 60085-2458 | 2008-07-02 |
| 1043481765 | Martha E. Diaz D.d.s., P.C. | Preferred Provider Organization | 2634 Grand Ave, Suite 207, Waukegan, IL 60085-2458 | 2008-03-20 |
| 1114143088 | Spine & Nerve Testing Center | Specialist/Technologist, Other | 2634 Grand Ave, Suite #101, Waukegan, IL 60085-2458 | 2007-04-18 |
| 1710045489 | Lee R Bomgaars | Dentist | 2634 Grand Ave, #106, Waukegan, IL 60085-2458 | 2006-12-05 |
| 1104928688 | Alyson Genell Marsalis | Counselor | 2634 Grand Ave, Suite 107, Waukegan, IL 60085-2458 | 2006-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285189 | Allison Rose Matuszewski | Speech-Language Pathologist | Robbie M. Lightfoot, 1721 N Mcaree Rd, Waukegan, IL 60085 | 2019-09-23 |
| 1164985602 | Kristin Kaprak | Speech-Language Pathologist | Thomas Jefferson Middle School, 600 S. Lewis, Waukegan, IL 60085 | 2019-04-11 |
| 1861972317 | Mitchum Smith | Student in an Organized Health Care Education/Training Program | 2025 Washington Street, Waukegan, IL 60085 | 2018-08-15 |
| 1447702998 | Rachel Martinez | Registered Nurse | 3002 Grand Ave., Waukegan, IL 60085 | 2016-11-01 |
| 1831649250 | Kenneth Caples | Specialist/Technologist | 211 S County St, Waukegan, IL 60085 | 2016-10-10 |
| 1033666490 | Catholic Charities of The Archdiocese of Chicago | Community/Behavioral Health | 671 S. Lewis Ave., Waukegan, IL 60085 | 2016-09-02 |
| 1285007757 | Michael Moore | Counselor | 1113 Greenwood Ave, Waukegan, IL 60085 | 2015-11-05 |
| 1740656503 | Emperatriz Guerra | Counselor | 329 N. Genesee Street, Waukegan, IL 60085 | 2015-08-17 |
| 1992189880 | County of Lake | Clinic/Center | 540 S. Mcalister Ave., Waukegan, IL 60085 | 2015-07-10 |
| 1922406354 | Ebele Okonkwor | Nurse Anesthetist, Certified Registered | 1324 N. Sheridan, Waukegan, IL 60085 | 2014-12-17 |
| Find all providers in zip 60085 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295992709 | Ronald C Hartzer | Dentist | 609 W Greenwood Ave, Waukegan, IL 60087-5000 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309399 | Dominik Dubravec Dds Mmsc PC | Dentist | 555 W Court St Ste 202, Kankakee, IL 60901-3674 | 2020-09-02 |
| 1598374167 | Dubravec Periodontal Specialists PC | Dentist | 20635 Abbey Woods Ct N Ste 203, Frankfort, IL 60423-3186 | 2020-07-29 |
| 1972145183 | Dental Dream Team Associates LLC Yetta Mccullom Sole Mbr | Dentist | 820 E 87th St Ste 201, Chicago, IL 60619-6256 | 2019-10-09 |
| 1083192389 | Amirreza Ghassemi | Dentist | 2800 College Ave Bldg 285, Alton, IL 62002-4742 | 2018-07-30 |
| 1508355678 | Periodontal Associates, LLP | Dentist | 845 N Michigan Ave Ste 940w, Chicago, IL 60611-2216 | 2018-05-04 |
| 1043750714 | Bloomingdale Dental Rez, PC | Dentist | 1 Tiffany Pt Ste 209, Bloomingdale, IL 60108-2916 | 2017-03-01 |
| 1114398831 | Dubravec Periodontal Associates, PC | Dentist | 1900 Spring Rd, Suite 205, Oak Brook, IL 60523-1447 | 2015-10-08 |
| 1689059297 | Amer Atassi | Dentist | 6224 S Elm St, Burr Ridge, IL 60527-5228 | 2015-07-24 |
| 1013304724 | Elliott T. Deweese | Dentist | 7447 W Talcott Ave., Suite 227, Chicago, IL 60631 | 2015-04-20 |
| 1215345939 | Mark Kolozenski, Dds, Ms, PC | Dentist | 10083 W Lincoln Hwy, Frankfort, IL 60423-1272 | 2014-07-25 |
| Find all providers with the same taxonomy | ||||
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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.