Active NPI
Debra Gordon, R.D.H.
- Dental Hygienist
- Tempe, AZ
National Provider Identifier
1003110065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 1491
- Practice address
- 6601 S Rural Rd
Tempe, AZ 85283-3747 - Phone
- (480) 831-5200
- NPI assigned
- Jan 5, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1491 | AZ | Primary |
Addresses
Primary practice location
6601 S Rural Rd
Tempe, AZ 85283-3747
Mailing address
PO Box 52108
Mesa, AZ 85208-0106
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1491 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309219200000",
"number": "1003110065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 52108",
"city": "MESA",
"state": "AZ",
"postal_code": "852080106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6601 S RURAL RD",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852833747",
"telephone_number": "480-831-5200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "DEBRA",
"name_prefix": "Ms.",
"credential": "R.D.H.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-05",
"last_updated": "2011-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "AZ",
"license": "1491",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.