Provider Demographics
NPI:1215943741
Name:GOSSETT, JAMES D (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:GOSSETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3013 INDEPENDENCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132
Mailing Address - Country:US
Mailing Address - Phone:830-625-6914
Mailing Address - Fax:830-629-5530
Practice Address - Street 1:3013 INDEPENDENCE DRIVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132
Practice Address - Country:US
Practice Address - Phone:830-625-6914
Practice Address - Fax:830-629-5530
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170231223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1567455-01Medicaid