NPIMap

Organization Active NPI

Gordon Dental Associates, LTD.

  • General Practice Dentistry
  • Olympia Fields, IL
National Provider Identifier
1932372547
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
GORDON DENTAL ASSOCIATES, LTD.
Practice address
2555 Lincoln Hwy
Suite 109
Olympia Fields, IL 60461-1936
Phone
(708) 679-0668
Fax
(708) 679-0667
NPI assigned
Apr 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Ronnie Anthony Gordon
Title
Business Development
Phone
(630) 926-5193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X IL Primary

Addresses

Primary practice location

2555 Lincoln Hwy
Suite 109
Olympia Fields, IL 60461-1936

Mailing address

2555 Lincoln Hwy
Suite 109
Olympia Fields, IL 60461-1936
Phone (708) 679-0668

National Provider Directory

National Provider Directory

Locations

2555 Lincoln Hwy
Ste 109
Olympia Fields, IL 60461
Phone (708) 679-0668

NPI Registry JSON

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1932372547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY",
            "address_2": "SUITE 109",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611936",
            "telephone_number": "708-679-0668",
            "fax_number": "708-679-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 LINCOLN HWY",
            "address_2": "SUITE 109",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611936",
            "telephone_number": "708-679-0668",
            "fax_number": "708-679-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON DENTAL ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "BUSINESS DEVELOPMENT",
        "authorized_official_telephone_number": "630-926-5193"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; 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.