Melinda P. Gordon D.M.D. a Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

32605 Issued in CA

Legal business name

MELINDA P. GORDON D.M.D. A DENTAL CORPORATION

Practice address

16935 Vanowen St. Suite a
Lake Balboa, CA 91406

Phone

(818) 705-2931

Fax

(818) 344-9565

NPI assigned

Oct 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Melinda Piega Gordon, D.M.D.NPI 1750714119

Title

President

Phone

(818) 705-2931

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melinda Piega Gordon, D.M.D.

  • Dentist
  • Lake Balboa, CA
  • NPI 1750714119
  NPD (past) Authorized official
• Elizabeth May Estrada, D.D.S.

  • General Practice Dentistry
  • Canoga Park, CA
  • NPI 1215117304
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053405118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16935 VANOWEN ST. SUITE A",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "91406",
            "telephone_number": "818-705-2931",
            "fax_number": "818-344-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16935 VANOWEN ST. SUITE A",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "91406",
            "telephone_number": "818-705-2931",
            "fax_number": "818-344-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELINDA P. GORDON D.M.D. A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "PIEGA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-705-2931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "32605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Lake Balboa, CA
• Providers in Lake Balboa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.