Gordon Miller Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GORDON MILLER DENTAL

Practice address

680 W Main St
Freehold, NJ 07728-2527

Phone

(732) 462-8770

NPI assigned

Aug 6, 2020

Organization subpart

No

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

Authorized official

Name

Jay Rana

Title

Director of Insurance

Phone

(908) 386-2443

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dental Health Associates South Jersey, P.A. Other name

Electronic endpoints 1

Locations

Practitioners 3

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

• Polina Chernyak, DDS

  • General Practice Dentistry
  • Freehold, NJ
  • NPI 1669851408
  NPD
• Robert M Gordon, DDS

  • General Practice Dentistry
  • Freehold, NJ
  • NPI 1003885476
  NPD (past)
• Jay Andrew Miller, DDS

  • General Practice Dentistry
  • Freehold, NJ
  • NPI 1730158106
  NPD (past)

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596931200000",
    "number": "1053921783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S MAIN ST FL 2",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652859",
            "telephone_number": "908-386-2443",
            "fax_number": "908-387-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 W MAIN ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077282527",
            "telephone_number": "732-462-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON MILLER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A",
        "authorized_official_last_name": "RANA",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "908-386-2443"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "NA",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "na",
            "affiliation": "N",
            "endpointDescription": "na",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "na",
            "address_1": "680 W Main St",
            "city": "Freehold",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "077282527",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Dental Health Associates South Jersey, P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Antero B Gonzales, M.D.
• Michael Gonzales, LCSW, LCADC
• Aimee Lynn Gonzalez, DACM, L. AC
• Kylee Gonzalez, APN
• Indu Gopal, MD
• Jill S Gordon, AUD
• Robert M Gordon, DDS
• Rosemarie Encinas Gozum
• Rashy Grace, M.B.B.CH.
• Elliot S. Grand, MD

• General Practice Dentistry in Freehold, NJ
• Providers in Freehold, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.