Gordon J Diehl DMD PC

Primary specialty

DentistTaxonomy code 122300000X

License

040755 Issued in NY

Legal business name

GORDON J DIEHL DMD PC

Practice address

176 Gnarled Hollow Road
East Setauket, NY 11733

Phone

(631) 689-1548

Fax

(631) 689-1516

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gordon Josef Diehl, DMDNPI 1316364128

Title

President

Phone

(631) 689-1548

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gordon Diehl

  • General Practice Dentistry
  • East Setauket, NY
  • NPI 1316364128
  NPD (past) Authorized official

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340755200000",
    "number": "1942364005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 GNARLED HOLLOW RD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-689-1548",
            "fax_number": "631-689-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 GNARLED HOLLOW ROAD",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "11733",
            "telephone_number": "631-689-1548",
            "fax_number": "631-689-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON J DIEHL DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2012-06-27",
        "status": "A",
        "authorized_official_last_name": "DIEHL",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "JOSEF",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-689-1548",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "040755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy R Goldstein, LCSW-R
• Jennifer Gonzalez, M.D.
• Mariano Gonzalez Jr., ATC
• David Goodrich, M.D.
• Chirayu V Gor, M.D.
• Farzan Gorgani, D.O.
• Katie Leigh Grady, NP
• William H Greene, M.D.
• Jessica Ms Gregory, L.AC.
• Jacqueline Ann Grempel, LMT

• Dentist in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2012; 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.