Provider Demographics
NPI:1629416748
Name:GOGEL, DANI JOELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:DANI
Middle Name:JOELLE
Last Name:GOGEL
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:181 HIGHWAY 44 E
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-6081
Mailing Address - Country:US
Mailing Address - Phone:502-955-2020
Mailing Address - Fax:502-736-4490
Practice Address - Street 1:544 CONESTOGA PKWY
Practice Address - Street 2:SUITE 17
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-5674
Practice Address - Country:US
Practice Address - Phone:502-955-2020
Practice Address - Fax:502-736-4490
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN18003782A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK086281Medicare Oscar/Certification