Gordon Clark Damon Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27147 Issued in TX

Practice address

1414 Texas St
Fort Worth, TX 76102-3426

Phone

(817) 336-2121

NPI assigned

Apr 4, 2011

Sex

Male

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Texas Denture Clinic, PC

  • Dental Clinic/Center
  • Fort Worth, TX
  • NPI 1407195290
  NPD (past) Authorized official
• Texas Denture Services, PLLC

  • Dentist
  • Fort Worth, TX
  • NPI 1285870386
  NPD (past)

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1407145022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 TEXAS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023426",
            "telephone_number": "817-336-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 TEXAS ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761023426",
            "telephone_number": "817-336-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMON",
        "first_name": "GORDON",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dionna M Dalzell, ARNP
• Mehar Daman, RBT
• Nancy N Dambro, MD
• Shyanne Dameron
• Peter J Damico, M.D
• Andrea L. Damron, CRNA
• Dan a. Willis, M.D., P.a.
• Dan Care LLC
• Dana Snell, D.O. P.L.L.C.
• Elisabeth Anne Danforth, APRN, FNP, AGACNP

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.