Melinda Piega Gordon, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

32605 Issued in CA

Practice address

16935 Vanowen St
Suite a
Lake Balboa, CA 91406-4595

Phone

(818) 705-2931

Fax

(818) 705-2931

NPI assigned

Aug 20, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Melinda P. Gordon D.M.D. a Dental Corporation

  • Dentist
  • Lake Balboa, CA
  • NPI 1053405118
  NPD (past) Authorized official

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1750714119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16935 VANOWEN ST",
            "address_2": "SUITE A",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064595",
            "telephone_number": "818-705-2931",
            "fax_number": "818-344-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16935 VANOWEN ST",
            "address_2": "SUITE A",
            "city": "LAKE BALBOA",
            "state": "CA",
            "postal_code": "914064595",
            "telephone_number": "818-705-2931",
            "fax_number": "818-705-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MELINDA",
        "middle_name": "PIEGA",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "32605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anik Janjughazyan, LMFT
• Patrick Zen Jen

• Dentist in Lake Balboa, CA
• Providers in Lake Balboa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.