Melvyn N Gorsen, D.D.S.,P.A.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI00847000 Issued in NJ

Practice address

1017 E Landis Ave
Vineland, NJ 08360-4043

Phone

(856) 692-4670

Fax

(856) 692-3068

NPI assigned

Feb 12, 2007

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

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376684290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 E LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604043",
            "telephone_number": "856-692-4670",
            "fax_number": "856-692-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 E LANDIS AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083604043",
            "telephone_number": "856-692-4670",
            "fax_number": "856-692-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORSEN",
        "first_name": "MELVYN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI00847000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Marie Gonzalez
• Courtney Nicole Good, LSW
• Marina Gordeyeva, O.D.
• Paige M Gorgo
• Holly Ann Gorsen, DMD
• Michael Seth Gorsen, D.D.S
• Wallena M Gould, CRNA
• Kayla Lanae Grablow, MA, LAC
• John W Graham, PT
• Rachael Graham

• General Practice Dentistry in Vineland, NJ
• Providers in Vineland, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.