Sigismund W Gordon Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901015550 Issued in MI

Practice address

20905 Greenfield Rd
Siute #601
Southfield, MI 48075-5360

Phone

(248) 569-6376

Fax

(248) 569-6377

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952525982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "SIUTE #601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-569-6376",
            "fax_number": "248-569-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 GREENFIELD RD",
            "address_2": "SIUTE #601",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755360",
            "telephone_number": "248-569-6376",
            "fax_number": "248-569-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "SIGISMUND",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4802910",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Elizabeth Goodwin, PHARMD
• Brianna Googe
• Lori Ellen Gordon-Michaeli, LMSW
• Charlene Brenda Gordon, M.A.
• Danielle Gordon
• Terry R. Gordon, M.D.
• Vicki Lee Gordon, RN NP
• Rebecca Gore
• Sarah Gorial, PA-C
• Stephen E Gork, D.D.S.

• General Practice Dentistry in Southfield, MI
• Providers in Southfield, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.