Douglas James Gordon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60918629 Issued in WA

Practice address

126 Auburn Ave Ste 100
Auburn, WA 98002-5082

Phone

(253) 804-8713

NPI assigned

Aug 13, 2006

Last updated

Dec 15, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: doug.gordon.p3@direct.hpc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthpoint

  dba HealthPoint SeaTac Dental

  • Federally Qualified Health Center (FQHC)
  • Seatac, WA
  • NPI 1831778620
  NPD (past)
• Chiyo Shidara D.D.S., Apc

  • General Practice Dentistry
  • Pinole, CA
  • NPI 1568821635
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607990400000",
    "number": "1457363707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 AUBURN AVE STE 100",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980025082",
            "telephone_number": "253-804-8713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2150 Appian Way",
            "address_2": "Ste 208",
            "address_purpose": "LOCATION",
            "city": "Pinole",
            "state": "CA",
            "postal_code": "94564",
            "country_code": "US",
            "telephone_number": "510-741-7100",
            "fax_number": "510-741-7335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DOUGLAS",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "CA25712",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60918629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medicalrecords.healthpoint.p3@direct.hpc.nextgenshare.com",
            "affiliation": "N",
            "address_1": "126 Auburn Ave Ste 100",
            "city": "Auburn",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980025082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gene Michael Gomez, MD
• Genevieve Gonzales
• Good Samaritan Senior Home LLC (Adult Family Home)
• Laini A Goodlett, RN
• Marchelle Goodman
• Jontaa Denise Gordon
• Sarah Gossett
• Noah Gottfred
• Grace Non-Emergency Medical Transportation LLC
• Gavan Daniel Graham, D.C.

• Dentist in Auburn, WA
• Providers in Auburn, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.