Gordon A Pringle, DDS PHD

Primary specialty

Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X

License

DS030417L Issued in PA

Practice address

3401 N Broad St
2ND Floor
Philadelphia, PA 19140-5103

Phone

(215) 707-4353

Fax

(215) 707-2053

NPI assigned

Oct 12, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265932800000",
    "number": "1174511257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827783",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191827783",
            "telephone_number": "215-707-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "address_2": "2ND FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "215-707-4353",
            "fax_number": "215-707-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINGLE",
        "first_name": "GORDON",
        "middle_name": "A",
        "credential": "DDS PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2010-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "PA",
            "license": "DS030417L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010266950001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prince Ofosu-Mensah, DMD, PC.
• David Keelty Prince, PSYD
• Jennifer Wai Prince, SLP-CCC
• Tamika Ann Prince
• Teena Prince
• Ka-Meach Pringle
• Tyresha Pringle
• Jivonne Nikell Prioleau-Green, HS
• Phoebe Gibson Prioleau, MD
• Yvonne D Prioleau, M.D.

• Clinical Pathology/Laboratory Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Pathology/Laboratory Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.