Active NPI
Scott Michael Gordon, D.D.S.
- Dentist
- Scranton, PA
National Provider Identifier
1497024475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DSO23084L
- Practice address
- 1238 N Main Ave
Scranton, PA 18508-2130 - Phone
- (570) 346-5015
- Fax
- (570) 346-5015
- NPI assigned
- Dec 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DSO23084L | PA | Primary |
Addresses
Primary practice location
1238 N Main Ave
Scranton, PA 18508-2130
Mailing address
1238 N Main Ave
Scranton, PA 18508-2130
Phone (570) 346-5015
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 |
|---|---|---|---|
| DSO23084L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324425600000",
"number": "1497024475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1238 N MAIN AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185082130",
"telephone_number": "570-346-5015",
"fax_number": "570-346-5015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1238 N MAIN AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185082130",
"telephone_number": "570-346-5015",
"fax_number": "570-346-5015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SCOTT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-21",
"last_updated": "2011-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DSO23084L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.