Gordon Rodney Stanger, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9685 Issued in OR

Practice address

200 Gwee Shut Rd
Siletz, OR 97380-2036

Phone

(541) 444-1030

NPI assigned

Nov 20, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, MT2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1321747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1518234426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 320",
            "city": "SILETZ",
            "state": "OR",
            "postal_code": "973800320",
            "telephone_number": "541-444-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GWEE SHUT RD",
            "city": "SILETZ",
            "state": "OR",
            "postal_code": "973802036",
            "telephone_number": "541-444-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANGER",
        "first_name": "GORDON",
        "middle_name": "RODNEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-20",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500662095",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Raymond Reid, CSWA
• Francisca Darlene Rilatos, CRM
• Joshua Rilatos, CRM
• William Smith
• Elizabeth Stam, LMT
• Lorene Stanger, O.D.
• Wylie Stokes, CRM, PRC
• Harmony Stout, CADC-R
• Corey Wayne Strong, CRM, NCTTP
• Ashley Evelyn Taylor, DDS

• General Practice Dentistry in Siletz, OR
• Providers in Siletz, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.