Gordon B Rosengren, DDS, Inc, PS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DE00004446 Issued in WA

Legal business name

GORDON B ROSENGREN, DDS, INC, PS

Practice address

24722 104TH Ave SE
Suite 201
Kent, WA 98030-5322

Phone

(253) 859-0123

Fax

(253) 859-5864

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gordon B. Rosengren, DDS

Title

President

Phone

(253) 859-0123

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Bruce Rosengren, D.D.S.

  • General Practice Dentistry
  • Kent, WA
  • NPI 1508093386
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730282054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24722 104TH AVE SE",
            "address_2": "SUITE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305322",
            "telephone_number": "253-859-0123",
            "fax_number": "253-859-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24722 104TH AVE SE",
            "address_2": "SUITE 201",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980305322",
            "telephone_number": "253-859-0123",
            "fax_number": "253-859-5864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON B ROSENGREN, DDS, INC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSENGREN",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-859-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE00004446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Goodale
• Brian Wayne Goodell, M.D.
• Charles Randall Gooding, SUDP
• Patricia Goodwin
• Olesya Gorbachevskaya, COTA
• Tia I Gordon
• Melissa Sue Goshe, MA ED
• Constance Gosnell
• George James Gosztola, D.D.S.
• Brianne Gould

• Dental Clinic/Center in Kent, WA
• Providers in Kent, WA by specialty
• Dental Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.