Active NPI
Stephney Elise Gordon, DDS
- Periodontics
- Bethel Park, PA
National Provider Identifier
1336353085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS029683L
- Practice address
- 2404 Oxford Dr
Bethel Park, PA 15102-1856 - Phone
- (412) 851-5060
- NPI assigned
- May 10, 2007
- Sex
- Female
- 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 | DS029683L | PA | Primary |
Addresses
Primary practice location
2404 Oxford Dr
Bethel Park, PA 15102-1856
Mailing address
206 Cedarbrook CT
McMurray, PA 15317-3545
Phone (724) 747-9253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS029683L | PA | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emmert Dental Assoc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Bethel Park, PA
- NPI 1740326511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336353085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 CEDARBROOK CT",
"city": "MCMURRAY",
"state": "PA",
"postal_code": "153173545",
"telephone_number": "724-747-9253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2404 OXFORD DR",
"city": "BETHEL PARK",
"state": "PA",
"postal_code": "151021856",
"telephone_number": "412-851-5060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "STEPHNEY",
"middle_name": "ELISE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS029683L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethel Park, PA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.