NPIMap

Organization Active NPI

Anita S. Gordon

Doing business as Gordon Family Dentistry

  • Point of Service
  • Atlanta, GA
National Provider Identifier
1144660283
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
DN009248 Issued in GA
Legal business name
ANITA S. GORDON
Doing business as
Gordon Family Dentistry
Practice address
2814 Buford Hwy NE
Atlanta, GA 30329-2103
Phone
(404) 486-7661
NPI assigned
Jul 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Authorized official

Name
Felecia Bryant
Title
Ofc Manager
Phone
(404) 486-7661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X DN009248 GA Primary

Addresses

Primary practice location

2814 Buford Hwy NE
Atlanta, GA 30329-2103

Mailing address

2814 Buford Hwy NE
Atlanta, GA 30329-2103
Phone (404) 486-7661

Other identifiers 1

IdentifierTypeStateIssuer
000225299AMedicaidGA

Other names 1

  • Gordon Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anita S Godon DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2814 Buford Hwy NE
Brookhaven, GA 30329
Phone (404) 486-7661

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1144660283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2814 BUFORD HWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292103",
            "telephone_number": "404-486-7661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2814 BUFORD HWY NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292103",
            "telephone_number": "404-486-7661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANITA S. GORDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "FELECIA",
        "authorized_official_title_or_position": "OFC MANAGER",
        "authorized_official_telephone_number": "404-486-7661"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "GA",
            "license": "DN009248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000225299A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gordon Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.