Philip J Gordon DDS PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

PHILIP J GORDON DDS PA

Practice address

3628 W 95TH St
Leawood, KS 66206-2035

Phone

(913) 649-5017

Fax

(913) 661-7186

NPI assigned

Jul 2, 2020

Organization subpart

No

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

Authorized official

Name

Philip Gordon, DDS

Title

Owner

Phone

(913) 649-5017

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1396362638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3628 W 95TH ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662062035",
            "telephone_number": "913-649-5017",
            "fax_number": "913-661-7186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3628 W 95TH ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662062035",
            "telephone_number": "913-649-5017",
            "fax_number": "913-661-7186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP J GORDON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-649-5017",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Peterson, APRN
• Michelle Renae Peterson, DNP, FNP
• Shelly Lynne Peterson, PHD
• Traci Peterson
• Mark T Pfefer, D.C.
• Evan Alan Phillips, O.D.
• Stacy D. Phillips, O.D.
• Physical Medicine and Rehab Experts LLC
• Physicians Reference Laboratory
• Tereasa Lynnette Pickert, PA-C

• Oral and Maxillofacial Surgery (Dentist) in Leawood, KS
• Providers in Leawood, KS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.