Donald R Gordon, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS017817-L Issued in PA

Practice address

3 Pine Tree Dr
Broomall, PA 19008-2740

Phone

(484) 485-7156

NPI assigned

May 10, 2006

Last updated

Nov 20, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Donald R Gordon & Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Broomall, PA
  • NPI 1700905478
  NPD (past) Authorized official
• Oral Surgery Consultants of Pennsylvania PC

  dba Oral surgery consultants of PA PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
  • NPI 1134250517
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1730138371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PINE TREE DR",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082740",
            "telephone_number": "484-485-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PINE TREE DR",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190082740",
            "telephone_number": "484-485-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN5723",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS017817-L",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "DA017817A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Joseph Golden, LCSW
• Andrew Goldenberg, DMD
• Ronald Scott Goldenberg, DMD
• Marjorie Vernette Gonzalez
• Patricia Jane Gonzalez, LPC, MT-BC
• Christina Gormley, MA CCC-SLP
• Taylor Gormley, MA, LBS, BCBA
• Elina Igorevna Gorovaya
• Jennifer Lynn Gowdy, IBCLC
• Suman Goyal, MD

• Oral and Maxillofacial Surgery (Dentist) in Broomall, PA
• Providers in Broomall, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2009; 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.