Organization Active NPI

Gda for Kids, Inc

  • General Practice Dentistry
  • Olympia Fields, IL
National Provider Identifier
1316892904
Registry record updated Feb 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GDA FOR KIDS, INC
Practice address
2555 Lincoln Hwy Ste 111
Olympia Fields, IL 60461-1938
Phone
(708) 679-0668
Fax
(708) 843-0656
NPI assigned
Feb 28, 2026
Last updated
Feb 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2026

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

Authorized official

Name
Ronnie A Gordon Sr.
Title
Executive Director
Phone
(708) 466-2374

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2555 Lincoln Hwy Ste 111
Olympia Fields, IL 60461-1938

Mailing address

2555 Lincoln Hwy Ste 111
Olympia Fields, IL 60461-1938
Phone (708) 679-0668

National Provider Directory

National Provider Directory

Locations

2555 Lincoln Hwy
Ste 111
Olympia Flds, IL 60461
Phone (708) 679-0668

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1772236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772236800000",
    "number": "1316892904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY STE 111",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611938",
            "telephone_number": "708-679-0668",
            "fax_number": "708-843-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY STE 111",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611938",
            "telephone_number": "708-679-0668",
            "fax_number": "708-843-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GDA FOR KIDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-28",
        "last_updated": "2026-02-28",
        "certification_date": "2026-02-28",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "708-466-2374",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2026; 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.