NPIMap

Organization Active NPI

Third Millennium Dental Group

  • General Practice Dentistry
  • Glendale, AZ
National Provider Identifier
1235348830
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2191 Issued in AZ
Legal business name
THIRD MILLENNIUM DENTAL GROUP
Doing business as
smile fitness dental center
Practice address
8284 W Union Hills Dr
Glendale, AZ 85308-8170
Phone
(623) 362-8200
Fax
(623) 362-8244
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Douglas Gordon, D.D.S.NPI 1871553867
Title
President
Phone
(623) 362-8200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2191 AZ Primary

Addresses

Primary practice location

8284 W Union Hills Dr
Glendale, AZ 85308-8170

Mailing address

8284 W Union Hills Dr
Glendale, AZ 85308-8170
Phone (623) 362-8200

Other names 1

  • smile fitness dental center Doing business as

National Provider Directory

National Provider Directory

Locations

8284 W Union Hills Dr
Glendale, AZ 85308
Phone (623) 362-8200

Practitioners & affiliated clinicians

Practitioners 3

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": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235348830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8284 W UNION HILLS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088170",
            "telephone_number": "623-362-8200",
            "fax_number": "623-362-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8284 W UNION HILLS DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088170",
            "telephone_number": "623-362-8200",
            "fax_number": "623-362-8244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD MILLENNIUM DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "623-362-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "2191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "smile fitness dental center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.