Glenn E. Gordon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00005995 Issued in WA

Practice address

16345 NE 87TH St
Ste C-2
Redmond, WA 98052-3503

Phone

(425) 883-8000

Fax

(425) 883-7580

NPI assigned

Aug 31, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Redmond, WA
  • NPI 1548253263

  General Practice

  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508850934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 E MEEKER ST",
            "address_2": "STE 300",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16345 NE 87TH ST",
            "address_2": "STE C-2",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980523503",
            "telephone_number": "425-883-8000",
            "fax_number": "425-883-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "GLENN",
        "middle_name": "E.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Christine Gonzales, MA, LMHCA
• Jocelyn D Gonzalez Aguilar
• Melissa Claire Gonzalez, PT, DPT, MS
• Cynthia Good, MS, LMHCA, IBCLC
• James Darwin Goodloe Jr.
• Lisa Barbara Gordon, M.S.
• Robin D Gouin, O.D.
• Jeneva H Grace
• Erin Katherine Graham, LMP
• Anna Elizabeth Graves, LICSW

• General Practice Dentistry in Redmond, WA
• Providers in Redmond, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.