Active NPI
Michael Steven Gorday, D.D.S., M.H.S.
- Periodontics
- San Antonio, TX
National Provider Identifier
1235261991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12835
- Practice address
- 1100 NW Loop 410
505
San Antonio, TX 78213-2263 - Phone
- (210) 341-6023
- Fax
- (210) 341-7332
- NPI assigned
- Mar 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 12835 | TX | Primary |
Addresses
Primary practice location
1100 NW Loop 410
505
San Antonio, TX 78213-2263
Mailing address
1207 High Rock St
San Antonio, TX 78232-3428
Phone (210) 495-0427
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110603000555 | TX | Practitioner - Oral Surgery | 3476730201 | Practice locations: San Antonio, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12835 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235261991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1207 HIGH ROCK ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782323428",
"telephone_number": "210-495-0427",
"fax_number": "210-495-3068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 NW LOOP 410",
"address_2": "505",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782132263",
"telephone_number": "210-341-6023",
"fax_number": "210-341-7332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDAY",
"first_name": "MICHAEL",
"middle_name": "STEVEN",
"credential": "D.D.S., M.H.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "12835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.