| Dr Alan R Gould, DDS, MS | |
|
5805 W Highway 22, Crestwood, KY 40014-7244 | |
| (502) 241-7116 | |
| (502) 241-2339 |
| Full Name | Dr Alan R Gould |
|---|---|
| Gender | Male |
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 5805 W Highway 22, Crestwood, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043229545 | NPI | - | NPPES |
| 2444790000 | Other | KY | PASSPORT ADVANTAGE |
| 200022760 | Medicaid | IN | |
| 6222055 | Other | CIGNA HEALTHCARE | |
| P00155545 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 12010715A (Indiana) | Secondary |
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 4925 (Kentucky) | Primary |
| Entity Name | Commonwealth Of Kentucky |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326467986 PECOS PAC ID: 0840180816 Enrollment ID: O20150415002129 |
| Entity Name | Vitalskin Medical Group Il Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477297083 PECOS PAC ID: 5991116261 Enrollment ID: O20220928002012 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Alan R Gould, DDS, MS 1941 Bishop Ln Ste 1018, Louisville, KY 40218-1928 Ph: (502) 456-6217 | Dr Alan R Gould, DDS, MS 5805 W Highway 22, Crestwood, KY 40014-7244 Ph: (502) 241-7116 |
Dr. David Todd Kamer, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 5301 W Hwy 146, Crestwood, KY 40014 Phone: 502-243-2400 Fax: 502-243-1281 | |
Dr. Thomas Jaggers Clark, DMD Dentist Medicare: Medicare Enrolled Practice Location: 5805 W Highway 22, Crestwood, KY 40014 Phone: 502-241-7116 Fax: 502-241-2339 | |
Dr. Trevor K Taylor, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 6435 W Highway 146, Suite 1, Crestwood, KY 40014 Phone: 502-241-1515 Fax: 502-241-1521 | |
Dr. Brittany Lynn Holeman, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 8815 W Highway 22, Crestwood, KY 40014 Phone: 502-241-8856 | |
Dr. Adam P Weisenbarger, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 8815 W Highway 22, Crestwood, KY 40014 Phone: 502-241-8856 | |
Titus Wongk, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 6344 W Highway 146 Ste 100, Crestwood, KY 40014 Phone: 502-241-4121 |