Active NPI
Spencer Preston Gordy, DDS
- General Practice Dentistry
- Conway, AR
National Provider Identifier
1477991065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3926
- Practice address
- 550 Chestnut St
Conway, AR 72032-5402 - Phone
- (501) 329-8754
- NPI assigned
- Jun 5, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3926 | AR | Primary |
Addresses
Primary practice location
550 Chestnut St
Conway, AR 72032-5402
Mailing address
1623 Center St
Little Rock, AR 72206-1415
Phone (501) 733-1677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3926 | AR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370390400000",
"number": "1477991065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 CENTER ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722061415",
"telephone_number": "501-733-1677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 CHESTNUT ST",
"city": "CONWAY",
"state": "AR",
"postal_code": "720325402",
"telephone_number": "501-329-8754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDY",
"first_name": "SPENCER",
"middle_name": "PRESTON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-05",
"last_updated": "2013-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AR",
"license": "3926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.