Marcena I Gorgaes, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022270 Issued in MI

Practice address

26113 Hoover Rd
Warren, MI 48089-1147

Phone

(586) 393-5686

NPI assigned

Jun 21, 2017

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Pro Dental Mi 1 PC

  • General Practice Dentistry
  • Warren, MI
  • NPI 1144057423
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498003200000",
    "number": "1356861447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26113 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480891147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26113 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480891147",
            "telephone_number": "586-393-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORGAES",
        "first_name": "MARCENA",
        "middle_name": "I",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Michael Goodman, D.D.S.
• Ronald Scott Goodman, D.D.S.
• Laurie E Gordon, DDS
• Kelsie Gore, LLMSW
• Christopher Gorecki, D.D.S.
• Yevgeniy Gorivodskiy, PA
• Burton David Gottlieb, MA LMSW
• Thomas Jacob Grabowski, DDS
• Grace and Gratitude Adult Care LLC
• Grace Family Care PC

• General Practice Dentistry in Warren, MI
• Providers in Warren, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.