NPIMap

Organization Active NPI

Patricia D Gordon

  • Dentist
  • Canoga Park, CA
National Provider Identifier
1992948780
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54899 Issued in CA
Legal business name
PATRICIA D GORDON
Practice address
21001 Covello Street
Canoga Park, CA 91303
Phone
(888) 556-0225
Fax
(323) 443-3904
NPI assigned
Apr 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Dr. Patricia Denise Gordon, D.D.S.
Title
Dentist
Phone
(888) 556-0225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 54899 CA Primary

Addresses

Primary practice location

21001 Covello Street
Canoga Park, CA 91303

Mailing address

21001 Covello Street
Canoga Park, CA 91303
Phone (888) 556-0225

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1992948780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 COVELLO STREET",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "91303",
            "telephone_number": "888-556-0225",
            "fax_number": "323-443-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 COVELLO STREET",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "91303",
            "telephone_number": "888-556-0225",
            "fax_number": "323-443-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA D GORDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-09",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "888-556-0225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "54899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canoga Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.