NPIMap

Organization Active NPI

Stout and Gordon Family Dentistry PLC

Doing business as Stout and Gordon Family Dentistry

  • General Practice Dentistry
  • Holland, MI
National Provider Identifier
1063537173
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018180 Issued in MI
Legal business name
STOUT AND GORDON FAMILY DENTISTRY PLC
Doing business as
Stout and Gordon Family Dentistry
Practice address
12723 N Bellwood St
Suite 30
Holland, MI 49424-7275
Phone
(616) 399-8230
Fax
(616) 399-8374
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Daniel Gordon, D.D.S.NPI 1790824944
Title
Dentist
Phone
(616) 399-8230

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2901018180 MI Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 2901014148 MI

Addresses

Primary practice location

12723 N Bellwood St
Suite 30
Holland, MI 49424-7275

Mailing address

12723 N Bellwood St
Suite 30
Holland, MI 49424-7275
Phone (616) 399-8230

Other names 1

  • Stout and Gordon Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

12723 N Bellwood Dr
Ste 30
Holland, MI 49424
Phone (616) 399-8230

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063537173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12723 N BELLWOOD ST",
            "address_2": "SUITE 30",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247275",
            "telephone_number": "616-399-8230",
            "fax_number": "616-399-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12723 N BELLWOOD ST",
            "address_2": "SUITE 30",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494247275",
            "telephone_number": "616-399-8230",
            "fax_number": "616-399-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOUT AND GORDON FAMILY DENTISTRY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-399-8230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018180",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901014148",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stout and Gordon Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holland, MI

Sources for this page

  • 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.