Angela Gordon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019-024669 Issued in IL

Practice address

2555 Lincoln Hwy
Suite 111
Olympia Fields, IL 60461-1936

Phone

(888) 675-0668

Fax

(708) 679-0670

NPI assigned

Nov 13, 2006

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Gda for Kids, Inc

  • General Practice Dentistry
  • Olympia Fields, IL
  • NPI 1316892904
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1851462634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY",
            "address_2": "SUITE 111",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611936",
            "telephone_number": "888-675-0668",
            "fax_number": "708-679-0670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY",
            "address_2": "SUITE 111",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611936",
            "telephone_number": "888-675-0668",
            "fax_number": "708-679-0670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-024669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Ann Golladay, MHS, CADC
• Aundrea Gooden
• Jaimie L Goodley
• Aravind Gopal, MD
• Gordon Dental Associates, LTD.
• Mateusz Dawid Gorecki, DO
• Kelli Lynn Goshay, RN
• Grace Home Health Services Inc
• Gracetouch Home Care Services
• James A Gramm

• General Practice Dentistry in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.