Jennifer Williamson Gordona, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.022813 Issued in OH

Practice address

105 E Ohio Ave
Mount Vernon, OH 43050-3528

Phone

(740) 392-1111

NPI assigned

Jun 19, 2008

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

Other names 1

• Dr. Jennifer Erin Williamson Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1881855088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E OHIO AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503528",
            "telephone_number": "740-392-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E OHIO AVE",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430503528",
            "telephone_number": "740-392-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDONA",
        "first_name": "JENNIFER",
        "middle_name": "WILLIAMSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.022813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "WILLIAMSON",
            "middle_name": "ERIN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rusti Goines
• Jaime T Goodman, M.D.
• Jeffrey N Goodman
• James T. Goodrich, M.D.
• Leah Beth Goodrich
• Mariah Gorrell, LSW
• Lauren Gorsuch
• Jennifer Gotschall, LPC/LCDCII
• Nicholas Alan Gotschall, MA, PCC
• Amy Lynn Gower

• General Practice Dentistry in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; 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.