Gordon K. Roediger, D.D.S., P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

2385 Issued in AZ

Legal business name

GORDON K. ROEDIGER, D.D.S., P.C.

Doing business as

Desert Dental Arts

Practice address

6127 N la Cholla Blvd Ste 175
Tucson, AZ 85741-3747

Phone

(520) 575-6216

Fax

(520) 575-6219

NPI assigned

Dec 31, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Kent Roediger, D.D.S.

Title

Dentist/Owner/President

Phone

(520) 575-6216

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Desert Dental Arts Doing business as

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1649455379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6127 N LA CHOLLA BLVD STE 175",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413747",
            "telephone_number": "520-575-6216",
            "fax_number": "520-575-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6127 N LA CHOLLA BLVD STE 175",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857413747",
            "telephone_number": "520-575-6216",
            "fax_number": "520-575-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON K. ROEDIGER, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "ROEDIGER",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "DENTIST/OWNER/PRESIDENT",
        "authorized_official_telephone_number": "520-575-6216",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "2385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093925232",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desert Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mukesh Gopalakrishnan, M.D.
• Felicia S Goraj
• Jeremy Michael Goral, FNP-C
• Shannon Lauren Goral, RDN, CDCES
• Gordon K. Roediger, D.D.S., Eastside, P.C. (Acacia Family Dental Group)
• David W Gordon, PA
• James D. Gordon, M.D.
• Kathleen Gordon, LCSW
• Lia Kay Gordon, FNP
• Lisa Gordon, MS

• Dentist in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 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.