Gordon B Davis MD DDS PS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

GORDON B DAVIS MD DDS PS

Practice address

1111 Pacific Ave
Suite a
Everett, WA 98201-4200

Phone

(425) 258-9586

Fax

(425) 259-1486

NPI assigned

Jul 20, 2010

Last updated

May 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gordon Bruce Davis, MD DDSNPI 1477641041

Title

President

Phone

(425) 348-1382

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gordon Bruce Davis, M.D., D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Everett, WA
  • NPI 1477641041
  Authorized official Same address or phone

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1073826996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9810 MARINE VIEW DR",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982754110",
            "telephone_number": "425-348-1382",
            "fax_number": "425-903-4402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 PACIFIC AVE",
            "address_2": "SUITE A",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014200",
            "telephone_number": "425-258-9586",
            "fax_number": "425-259-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON B DAVIS MD DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-348-1382",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L Goodman, MD
• Christina Kay Goodno, RRT
• Vikram Manjunath Gopal, D.O.
• Bethany Smith Gopalakrishnan, PT, DPT
• Natiya Gorden
• Katherynn E. Gordon-Sawiris, LCSW
• Andrea Jean Gordon
• Catia Gordon
• Chelsea Rae Holzinger Gordon, N.D.
• David M. Gordon, MD

• Oral and Maxillofacial Surgery (Dentist) in Everett, WA
• Providers in Everett, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.