Douglass K Gordon, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30019792 Issued in OH

Practice address

140 Shawnee St
Greenville, OH 45331-2529

Phone

(937) 548-0755

Fax

(937) 548-9787

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346337763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SHAWNEE ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453312529",
            "telephone_number": "937-548-0755",
            "fax_number": "937-548-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SHAWNEE ST",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "453312529",
            "telephone_number": "937-548-0755",
            "fax_number": "937-548-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DOUGLASS",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30019792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyson Lee Gerstner
• Robert A Girmann, M.D.
• Rachel Glass, M.ED.
• Sarah Godfrey
• Megan Goewert
• Lawrence A Gould, M.D.
• Brooke Nicole Gower, PHARMD
• Julia Gower, LPC
• Laurie K Grachek-White, PHD, LISW
• Greenville Al, LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Greenville, OH
• Providers in Greenville, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• 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.

Verify at the official NPI Registry.