Kassandra Marie Gordon, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H06423 Issued in AZ

Practice address

18610 E Rittenhouse Rd Ste 103
Queen Creek, AZ 85142-4504

Phone

(480) 807-4000

NPI assigned

Apr 10, 2023

Last updated

Apr 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1780379180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3539 E PHELPS ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852952140",
            "telephone_number": "480-326-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18610 E RITTENHOUSE RD STE 103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851424504",
            "telephone_number": "480-807-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "KASSANDRA",
        "middle_name": "MARIE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "AZ",
            "license": "H06423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Health Medical, PLLC (My Dr Now)
• Good Health Medical, PLLC (My Dr Now)
• Good Health Medical, PLLC (My Dr Now)
• Good Life Dental
• Zachary Goodenberger, RBT
• Tina Marie Gordon
• Evan McFarlin Goreham
• Jade Faith Gottschalk, DDS
• Graceful Path Psychiatry, PLLC
• Dorsey Gradis, ANP

• Dental Hygienist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Dental Hygienist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; 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.