Stephen E. Gork, DDS,PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12696 Issued in MI

Legal business name

STEPHEN E. GORK, DDS,PC

Practice address

26771 W 12 Mile Rd
G-115
Southfield, MI 48034-1539

Phone

(248) 353-7440

Fax

(248) 353-3148

NPI assigned

May 19, 2015

Organization subpart

No

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

Authorized official

Name

Stephen Edward Gork, DDS

Title

President

Phone

(248) 353-7440

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431993600000",
    "number": "1073992483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26771 W 12 MILE RD",
            "address_2": "G-115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341539",
            "telephone_number": "248-353-7440",
            "fax_number": "248-353-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26771 W 12 MILE RD",
            "address_2": "G-115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341539",
            "telephone_number": "248-353-7440",
            "fax_number": "248-353-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN E. GORK, DDS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2015-05-19",
        "status": "A",
        "authorized_official_last_name": "GORK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-353-7440",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "12696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; 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.