Cecille Gordon, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

045979 Issued in NY

Practice address

128 Stevens Ave
Mt Vernon, NY 10550-2604

Phone

(914) 668-2772

Fax

(914) 668-2657

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679791453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 LAWN AVE",
            "address_2": "UNIT #12",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 STEVENS AVE",
            "city": "MT VERNON",
            "state": "NY",
            "postal_code": "105502604",
            "telephone_number": "914-668-2772",
            "fax_number": "914-668-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CECILLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045979",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Gonzalez
• Kathy Gonzalez
• Maday C Gonzalez, M.D.
• Eldonia Goode
• Elias Steven Gootzeit, L.C.S.W
• Lemar Anthony Gordon, LPN
• Randall Gordon Jr.
• Kiana Goshorn
• Monique Graham, RN
• Gramatan Health Supplies LLC

• General Practice Dentistry in Mt Vernon, NY
• Providers in Mt Vernon, NY by specialty
• General Practice Dentistry in New York

• 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.