Individual provider Active NPI

Gordon Charles Gaynor, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bronx, NY
National Provider Identifier
1578766853
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
23581 Issued in NY
Practice address
3515 Henry Hudson Pkwy
Bronx, NY 10463-1326
Phone
(718) 543-4300
Fax
(718) 601-0954
NPI assigned
Jun 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 23581 NY Primary

Addresses

Primary practice location

3515 Henry Hudson Pkwy
Bronx, NY 10463-1326

Mailing address

3515 Henry Hudson Pkwy
Bronx, NY 10463-1326
Phone (718) 543-4300

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

LicenseStateTypeSpecialty
23581NYMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578766853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 HENRY HUDSON PKWY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631326",
            "telephone_number": "718-543-4300",
            "fax_number": "718-601-0954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 HENRY HUDSON PKWY",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104631326",
            "telephone_number": "718-543-4300",
            "fax_number": "718-601-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYNOR",
        "first_name": "GORDON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "23581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • 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.