NPIMap

Organization Active NPI

Donald G Gardner DDS, Inc.

  • Oral and Maxillofacial Surgery (Dentist)
  • Stafford, TX
National Provider Identifier
1184884009
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
TX11037 Issued in TX
Legal business name
DONALD G GARDNER DDS, INC.
Practice address
4915 S Main St
Suite 118
Stafford, TX 77477-4601
Phone
(281) 491-4545
Fax
(281) 491-7134
NPI assigned
Jun 13, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Donald George Gardner, D.D.S.
Title
Doctor
Phone
(281) 491-4545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X TX11037 TX Primary

Addresses

Primary practice location

4915 S Main St
Suite 118
Stafford, TX 77477-4601

Mailing address

4915 S Main St
Suite 118
Stafford, TX 77477-4601
Phone (281) 491-4545

Other identifiers 2

IdentifierTypeStateIssuer
1108623-04MedicaidTX
1544389-01MedicaidTX

National Provider Directory

National Provider Directory

Locations

4915 S Main St
Ste 118
Stafford, TX 77477
Phone (281) 491-4545

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1184884009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 S MAIN ST",
            "address_2": "SUITE 118",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774601",
            "telephone_number": "281-491-4545",
            "fax_number": "281-491-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 S MAIN ST",
            "address_2": "SUITE 118",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774601",
            "telephone_number": "281-491-4545",
            "fax_number": "281-491-7134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD G GARDNER DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-13",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "281-491-4545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "TX11037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1108623-04",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1544389-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.