DR. GORDON CLELAND FRASER JR. (NPI# 1306034871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306034871 |
| Entity Type | Individual |
| Full Name | DR. GORDON CLELAND FRASER JR. |
| Credential | DMD |
| Practice Address |
1916 Iris Drive Conyers GA 30094 |
| Mailing Address |
P.o. Box 2213 Peachtree City GA 30269 |
| Practice Telephone | 7704834469 |
| Practice Fax Number | 7709220401 |
| Mailing Telephone | 7704834469 |
| Mailing Fax Number | 7709220401 |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2016-05-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
DN012684 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922140482 | Gordon Cleland Fraser | Obstetrics & Gynecology | 8475 S Van Ness Ave, Ste 104 Gordon C Frazer Md Inc, Inglewood, CA 90305 | 2007-02-13 |
| Street Address |
1916 IRIS DRIVE |
| City | CONYERS |
| State | GA |
| Zip Code | 30094 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003950247 | Robert H Creager | Dentist | 1463 Klondike Rd Sw, Suite A, Conyers, GA 30094-5103 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420146 | Scott Hansen Lowry | Dentist | 1430 John Wesley Drive, Augusta, GA 30912-0001 | 2020-02-25 |
| 1780233981 | North Point Periodontics Center LLC | Dentist | 4205 N Point Pkwy Ste A, Alpharetta, GA 30022-8808 | 2019-09-10 |
| 1972012961 | Newnan Periodontics LLC | Dentist | 1635 Highway 34 E Ste A, Newnan, GA 30265-2173 | 2017-09-22 |
| 1871948695 | Kyle Garrett | Dentist | 2704 W Terrace Dr, Augusta, GA 30909-3622 | 2016-04-29 |
| 1346601291 | Titanium Dental | Dentist | 3796 Satellite Blvd Ste 101, Duluth, GA 30096-5698 | 2016-03-18 |
| 1073972584 | Kara Kramer | Dentist | 2970 Peachtree Rd Nw Ste 622, Atlanta, GA 30305-2115 | 2016-02-12 |
| 1922491356 | John H Eaton | Dentist | 1776 Old Spring House Ln Ste 301, Dunwoody, GA 30338-6225 | 2015-03-10 |
| 1679977656 | M Forest Butler Dds Ms PC | Dentist | 320 Killian Hill Rd Nw, Lilburn, GA 30047-3809 | 2014-10-20 |
| 1790196467 | Wranglehurst, P.C. | Dentist | 3850 Holcomb Br. Rd, Suite 230, Norcross, GA 30092 | 2014-05-15 |
| 1699104927 | Nisha Maniar Kancherla | Dentist | 300 W Wieuca Rd Ne Suite 100, Atlanta, GA 30342-9701 | 2013-11-07 |
| Find all providers with the same taxonomy | ||||
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| 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.