Individual provider Active NPI

Gordon James Block, D.D.S.

  • Endodontics
  • Sunnyvale, CA
National Provider Identifier
1891890513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
24362 Issued in CA
Practice address
1565 Hollenbeck Ave
Suite #106
Sunnyvale, CA 94087-5922
Phone
(408) 739-9700
Fax
(408) 739-2617
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 24362 CA Primary

Addresses

Primary practice location

1565 Hollenbeck Ave
Suite #106
Sunnyvale, CA 94087-5922

Mailing address

1565 Hollenbeck Ave
Suite #106
Sunnyvale, CA 94087-5922
Phone (408) 739-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20231024004195 CA Order and Referring Only - DentistPractitioner - Dentist 5597111716

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24362CAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891890513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 HOLLENBECK AVE",
            "address_2": "SUITE #106",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940875922",
            "telephone_number": "408-739-9700",
            "fax_number": "408-739-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 HOLLENBECK AVE",
            "address_2": "SUITE #106",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940875922",
            "telephone_number": "408-739-9700",
            "fax_number": "408-739-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCK",
        "first_name": "GORDON",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "24362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.