Michael L Gordon DMD Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

30014084 Issued in OH

Legal business name

MICHAEL L GORDON DMD INC

Practice address

3544 Springdale Rd
Cincinnati, OH 45251-1331

Phone

(513) 385-6555

Fax

(513) 385-2833

NPI assigned

Mar 27, 2008

Last updated

Mar 27, 2008By 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

Dr. Michael Lewis Gordon, D.M.D.

Title

President

Phone

(513) 385-6555

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1164694311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 SPRINGDALE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452511331",
            "telephone_number": "513-385-6555",
            "fax_number": "513-385-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 SPRINGDALE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452511331",
            "telephone_number": "513-385-6555",
            "fax_number": "513-385-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L GORDON DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-385-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "30014084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0215565",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.