MARK J GORDON (NPI# 1386643740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386643740 |
| Entity Type | Individual |
| Full Name | MARK J GORDON |
| Credential | DDS |
| Practice Address |
4121 W 83rd St Suite 212 Prairie Village KS 66208-5300 |
| Practice Telephone | 9136494042 |
| Practice Fax Number | 9136498898 |
| Mailing Telephone | 9136494042 |
| Mailing Fax Number | 9136498898 |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 013474 | MO | Dental Providers |
| Y | 122300000X | Dentist | 5900 | KS | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | BCBS | 09533-01-8 | 01 |
| KS | BCBS | 79345 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497183404 | Mark Gordon | Homemaker | 16938 S Dixie Hwy, Palmetto Bay, FL 33157-4354 | 2013-10-30 |
| 1750409629 | Mark A Gordon | Physician Assistant | 13601 Wood Forest Blvd, Houston, TX 77015 | 2007-03-27 |
| 1356365126 | Mark Richard Gordon | Dentist | 2121 Eisenhower Ave, Suite 502, Alexandria, VA 22314-4698 | 2006-07-26 |
| 1568420099 | Mark Jay Gordon | Optometrist | 978 Colvin Blvd, Kenmore, NY 14217-2128 | 2006-05-03 |
| 1396734331 | Mark Howard Gordon | Dentist | 15 Fletcher Ave, Valley Stream, NY 11580-4000 | 2005-10-20 |
| 1528489184 | Mark Gordon | Nurse Anesthetist, Certified Registered | 1 Saint Joseph Dr, Lexington, KY 40504-3742 | 2013-12-30 |
| 1841576543 | Mark Gordon | Pharmacist | 1305 N Casaloma Dr, Grand Chute, WI 54913-8848 | 2011-10-25 |
| 1306987946 | Mark Lorry Gordon | Family Medicine | 16661 Ventura Blvd, Suite 716, Encino, CA 91436-1914 | 2007-02-08 |
| 1891869202 | Mark Gordon | Optometrist | 230 W Jersey St, Suite 201, Elizabeth, NJ 07202-1364 | 2006-11-17 |
| 1821028382 | Mark B Gordon | Optometrist | 100 Park Ave, Baltimore, MD 21201-3416 | 2006-07-03 |
| Street Address |
4121 W 83RD ST SUITE 212 |
| City | PRAIRIE VILLAGE |
| State | KS |
| Zip Code | 66208-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083065510 | Rosemarie A Romain-tyson LLC | Psychiatry & Neurology | 4121 W 83rd St, 254, Prairie Village, KS 66208-5300 | 2016-06-27 |
| 1912364266 | Stacey Laird, Md, LLC | Psychiatry & Neurology | 4121 W 83rd St, Ste. 204, Prairie Village, KS 66208-5472 | 2016-01-18 |
| 1821346495 | Stacey Allison Laird | Psychiatry & Neurology | 4121 W 83rd St, Suite 204, Prairie Village, KS 66208-5472 | 2012-08-29 |
| 1538492988 | Byron A Milgram Professional Corp | Psychiatry & Neurology | 4121 W 83rd St, 123, Prairie Village, KS 66208-5300 | 2009-09-16 |
| 1063605608 | Rostberg Chiropractic & Acupuncture, P.a. | Chiropractor | 4121 W 83rd St, Suite 204, Prairie Village, KS 66208-5300 | 2007-08-27 |
| 1669689188 | Vellore Kirubakaran M D P A | Psychiatry & Neurology | 4121 W 83rd St, Suite 254, Prairie Village, KS 66208-5300 | 2007-05-16 |
| 1881711083 | Garydeanzuck, Dds,pa | Dentist | 4121 W 83rd St, Suite 200, Prairie Village, KS 66208-5300 | 2007-03-23 |
| 1619009172 | Vellore Kirubakaran | Psychiatry & Neurology | 4121 W 83rd St, Suite 254, Prairie Village, KS 66208-5300 | 2007-03-11 |
| 1528111531 | Barbara B Hise | Counselor | 4121 W 83rd St, Suite 161, Prairie Village, KS 66208-5300 | 2007-01-21 |
| 1447308556 | Arnold Steven Hermanson | Dentist | 4121 W 83rd St, Suite 220, Prairie Village, KS 66208-5300 | 2007-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627940 | Arena Health LLC | Clinic/Center | 8010 Stateline Road, Suite 100, Prairie Village, KS 66208 | 2020-07-27 |
| 1780222414 | Tracy Licausi | Counselor | 4907 W 69th Ter, Prairie Village, KS 66208 | 2019-12-12 |
| 1699294959 | Meredith Arends | Physician Assistant | 2904 W 73rd Street, Prairie Village, KS 66208 | 2017-09-18 |
| 1861914616 | Pardeep Kaur Gill | Dentist | 7501 Mission Rd Ste 102, Prairie Village, KS 66208 | 2017-07-13 |
| 1366821977 | Wineteer, Inc. | Durable Medical Equipment & Medical Supplies | 3500 W 75th St, Suite 100, Prairie Village, KS 66208 | 2015-05-28 |
| 1972913374 | Julia Nguyen | Dentist | 7301 Mission Rd Ste 317, Prairie Village, KS 66208 | 2014-05-07 |
| 1063859650 | Joseph Charles Glenn | Chiropractor | 8016 State Line Rd, Suite 100, Leawood, KS 66208 | 2013-05-23 |
| 1104172337 | Julie Anne Budke | Psychologist | 3965 W 83rd Street Suite 233, Prairie Village, KS 66208 | 2012-07-25 |
| 1700149952 | Julia K Thomas | Specialist | 5111 W. 64th St, Prairie Village, KS 66208 | 2012-06-22 |
| 1255624227 | Carl S Cleveland Iv | Chiropractor | 8016 State Line Rd, Ste 100, Leawood, KS 66208 | 2011-05-24 |
| Find all providers in zip 66208 | ||||
| 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 |
|---|---|---|---|---|
| 1124538608 | Emergency Dental of Kansas City, LLC | Dentist | 3700 W 83rd St Ste 111, Prairie Village, KS 66208-5120 | 2017-10-10 |
| 1790117448 | Clark Christopher Chaney | Dentist | 4121 W 83rd St Ste 206, Prairie Village, KS 66208-5323 | 2013-08-05 |
| 1215172275 | Theodore Constantine Dimas | Dentist | 4121 W. 83 St., Suite 230, Prairie Village, KS 66208-5303 | 2008-12-04 |
| 1639201197 | Stephen Bernat Koshland | Dentist | 7301 Mission Rd Ste 200, Prairie Village, KS 66208-3031 | 2007-03-11 |
| 1982731543 | Diane Dyer-chenoweth | Dentist | 7501 Mission Rd Ste N11, Prairie Village, KS 66208-4282 | 2007-02-28 |
| 1982748984 | Stephanie M. Warden, D.d.s., P.a. | Dentist | 2200 W 75th St, Suite 101, Prairie Village, KS 66208-3505 | 2007-02-16 |
| 1861567935 | Susan A. Cope | Dentist | 9003 Roe Ave, Prairie Village, KS 66207-2202 | 2006-11-22 |
| 1699854752 | Kevin Joseph Krause | Dentist | 9401 Nall Ave, Suite 201, Prairie Village, KS 66207-2515 | 2006-11-02 |
| 1952373292 | John N Jordan | Dentist | 7501 Mission Rd, #n-1, Prairie Village, KS 66208-4217 | 2006-02-02 |
| 1952371361 | Robert M Browne | Dentist | 7510 State Line Rd, Ste C, Prairie Village, KS 66208 | 2006-01-26 |
| Find all providers in PRAIRIE VILLAGE | ||||
| City | PRAIRIE VILLAGE |
| Zip Code | 66208 |
Please comment or provide details below to improve the information on MARK J GORDON.
| 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.