PETRA GORDON DMD PLLC (NPI# 1154708097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154708097 |
| Entity Type | Organization |
| Organization Name | PETRA GORDON DMD PLLC |
| Practice Address |
609 Lamar Ave Brooksville FL 34601-3211 |
| Practice Telephone | 3527962034 |
| Practice Fax Number | 8885819789 |
| Mailing Telephone | 3527962034 |
| Mailing Fax Number | 8885819789 |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |
| Authorized Official Name | DR. PETRA G LEE (OWNER) |
| Authorized Official Telephone | 3527962034 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DN 17627 | FL | Dental Providers |
| Street Address |
609 LAMAR AVE |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34601-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326108754 | Petra G Lee | Dentist | 609 Lamar Ave, Brooksville, FL 34601-3211 | 2006-12-08 |
| 1023158862 | George Wallace Boring Jr. | Dentist | 609 Lamar Ave, Brooksville, FL 34601 | 2007-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811526643 | Benzer Fl 39 LLC | Pharmacy | 80 Ponca De Leon Blvd, Brooksville, FL 34601 | 2020-04-03 |
| 1245868702 | Karon Elaine Stagg | Specialist/Technologist | 20158 Cortez Blvb, Brookesville, FL 34601 | 2020-03-31 |
| 1699253666 | Shedding Light Counseling 'llc' | Counselor | 24059 Cortez Blvd, Brooksville, FL 34601 | 2018-08-01 |
| 1265952162 | Tysheeca Deandrea Washington | Assistant Behavior Analyst | 1535 Greenbriar Villa Circle, Brooksville, FL 34601 | 2017-06-21 |
| 1386179836 | Andrew Bishay | Emergency Medical Technician, Intermediate | 7284 Broad St, Brooksville, FL 34601 | 2017-04-21 |
| 1265892152 | Ralph Vitola | Pharmacist | 218 S. Broad St., Brooksville, FL 34601 | 2016-03-04 |
| 1689018301 | Nic 4 The Grande Leasing LLC | Assisted Living Facility | 725 Desoto Avenue, Brooksville, FL 34601 | 2013-04-24 |
| 1023301496 | Gerald Warren Springstead | Dentist | 605 W. Jefferson St., Brooksville, FL 34601 | 2011-05-18 |
| 1417280330 | Growing Center Counseling | Counselor | 275 W. Jefferson St., Brooksville, FL 34601 | 2009-09-10 |
| 1073663118 | Jennifer Suiters | Social Worker | 706 Ponce De Leon Blvd, Brooksville, FL 34601 | 2007-01-11 |
| Find all providers in zip 34601 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023301496 | Gerald Warren Springstead | Dentist | 605 W. Jefferson St., Brooksville, FL 34601 | 2011-05-18 |
| 1568633931 | Dr. Gary L. Mccord | Dentist | 224 Frankfort Street, Brooksville, KY 41004 | 2008-03-13 |
| 1427269877 | Douglas Fredric Roth | Dentist | 18134 Powell Rd, Brooksville, FL 34601-1813 | 2007-05-25 |
| 1326180134 | Basappa Mruthyunjaya | Dentist | 14539 Cortez Blvd, Brooksville, FL 34613-6065 | 2007-02-12 |
| 1649321845 | Bryan Timothy Marshall | Dentist | 12009 Cortez Blvd, Brooksville, FL 34613-7372 | 2007-01-15 |
| 1447352794 | Kimberly Henwood | Dentist | 13146 Cortez Blvd, Brooksville, FL 34613-4858 | 2006-09-05 |
| 1831712637 | Rita Dee Raffoul | Dentist | 12009 Cortez Blvd, Brooksville, FL 34613-7372 | 2020-05-27 |
| 1740730613 | Dental Associates of Florida (brooksville) Pllc | Dentist | 401 Howell Ave, Brooksville, FL 34601-2044 | 2016-10-04 |
| 1215326830 | Juan C Fabrega | Dentist | 18134 Powell Rd, Brooksville, FL 34604-8141 | 2015-01-20 |
| 1477952356 | Dental Associates of Brooksville | Dentist | 401 Howell Ave, Brooksville, FL 34601-2044 | 2014-08-18 |
| Find all providers in BROOKSVILLE | ||||
| City | BROOKSVILLE |
| Zip Code | 34601 |
Please comment or provide details below to improve the information on PETRA GORDON DMD PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.