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DR. JEFFERSON B GOURLEY DDS
NPI 1003941170
Dentist - Endodontics in Salem, OR

Active since February 22, 2007PECOS Enrolled
3490 LANCASTER DR NE, SALEM, OR 97305(855) 433-6825 Get Directions Write a Review

NPPES record last updated: May 19, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 19, 2021, Mar 5, 2019 (2 updates tracked since 2019).

About Dr. Jefferson B Gourley Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEFFERSON B GOURLEY DDS (NPI 1003941170) is an individual endodontics provider in Salem, Oregon, licensed in Oregon (D11009) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003941170
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. JEFFERSON B GOURLEYCredential: DDS
Location Address3490 LANCASTER DR NESalem, OR 97305-1356
Mailing Address6950 Ne Campus WayHillsboro, OR 97124-5611 · (855) 433-6825
Phone(855) 433-6825
Sole ProprietorNo
Enumeration DateFebruary 22, 2007
Last NPPES UpdateMay 19, 20212 updates tracked since enumeration
NPPES CertifiedMay 19, 2021
✔ NPI 1003941170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
Licenses✔ Licensed in OR · D11009✔ Licensed in WA · DE60502349
Definition
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
3490 LANCASTER DR NE, Salem, OR 97305
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jefferson B Gourley Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERDA CARMEL PRADEL D.M.D.
Dentist (Oral and Maxillofacial Surgery)
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (855) 433-6825
TANYA LYNN ARTHUR RDH
Dental Hygienist
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 540-9041
GUINEVERE NOELLE TADINA RDH
Dental Hygienist
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (855) 433-6825
AIMEE RENEE AXTELL RDH
Dental Hygienist
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 540-9041
MR. RONALD DAVID JAY WRIGHT RDH
Dental Hygienist
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (800) 461-8994
DR. MARY ANN YOO DDS
Dentist
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (503) 540-9041
DR. YING WAN DDS, MS
Dentist (Orthodontics and Dentofacial Orthopedics)
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (855) 433-6825
RACHEL LEE MEANS DMD
Dentist
3490 LANCASTER DR NE
SALEM, OR 97305
Marion County (855) 433-6825

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jefferson Gourley's NPI number?

The NPI number for Jefferson Gourley is 1003941170. It was assigned to this individual provider in the NPPES registry on February 22, 2007.

Where is Jefferson Gourley located?

Jefferson Gourley practices at 3490 Lancaster Dr NE, Salem, OR 97305. The listed phone number is (855) 433-6825.

What is Jefferson Gourley's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Jefferson Gourley enrolled in Medicare?

Yes. Jefferson Gourley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jefferson Gourley was last updated on May 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.