Active NPI
William Michael Gordon, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Coventry, RI
National Provider Identifier
1730152182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- RI2421
- Practice address
- 840 Tiogue Ave
Coventry, RI 02816 - Phone
- (401) 828-1171
- Fax
- (401) 828-4704
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | RI2421 | RI | Primary |
Addresses
Primary practice location
840 Tiogue Ave
Coventry, RI 02816
Mailing address
840 Tiogue Ave
Coventry, RI 02816
Phone (401) 828-1171
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
| License | State | Type | Specialty |
|---|---|---|---|
| RI2421 | RI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ri Specialty Dental Services, LLC | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Coventry, RI
- NPI 1336912112
Orthodontics and Dentofacial Orthopedics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1730152182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 TIOGUE AVE",
"city": "COVENTRY",
"state": "RI",
"postal_code": "02816",
"telephone_number": "401-828-1171",
"fax_number": "401-828-4704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 TIOGUE AVE",
"city": "COVENTRY",
"state": "RI",
"postal_code": "02816",
"telephone_number": "401-828-1171",
"fax_number": "401-828-4704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "WILLIAM",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "RI",
"license": "RI2421",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coventry, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.