DR. JEREMIAH DANIEL GORDON (NPI# 1497870646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497870646 |
Entity Type | Individual |
Full Name | DR. JEREMIAH DANIEL GORDON |
Credential | DMD |
Practice Address |
135 Jenkins St Suite 105a St Augustine FL 32086-5175 |
Mailing Address |
53 Willow Dr St Augustine FL 32080-5936 |
Practice Telephone | 9044600999 |
Practice Fax Number | 9044600999 |
Enumeration Date | 2007-03-20 |
Last Update Date | 2009-02-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 122300000X | Dentist | DN16348 | FL | Dental Providers |
Street Address |
135 JENKINS ST SUITE 105A |
City | ST AUGUSTINE |
State | FL |
Zip Code | 32086-5175 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568785426 | Dr Ted Brink & Associates | Optometrist | 135 Jenkins St, Ste104, St Augustine, FL 32086-5175 | 2010-03-08 |
1750610986 | Pearle Vision Inc | Eyewear Supplier (Equipment, not the service) | 135 Jenkins St, Cobblestone Village Ste #104, St Augustine, FL 32086-5175 | 2009-12-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
Find all providers in zip 32086 |
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 |
---|---|---|---|---|
1780200634 | Phillip Forbes | Dentist | 405 S Ponce De Leon Blvd, St Augustine, FL 32084-4219 | 2020-06-17 |
1861048043 | Tanjeet Cheema | Dentist | 1980 Us Highway 1 S, St Augustine, FL 32086-4233 | 2019-08-14 |
1073035911 | Rusha G Awad | Dentist | 46 Tuscan Way Ste 306, St Augustine, FL 32092-1849 | 2017-07-12 |
1770817389 | Emily Weldon Tyler | Dentist | 2510 Us Highway 1 S, Suite B, St Augustine, FL 32086-6100 | 2009-09-29 |
1982868634 | Steven R. Freeman Dds Pl | Dentist | 319 W Town Pl Ste 21, St Augustine, FL 32092-3103 | 2008-07-11 |
1053578690 | Maria Zita Narvaez | Dentist | 303a Anastasia Blvd, St Augustine, FL 32080-4506 | 2008-05-21 |
1972789725 | Michael Andrew Versaggi | Dentist | 150 Malaga St, St Augustine, FL 32084-3521 | 2008-01-10 |
1720284698 | Rex Beasom Painter | Dentist | 10 Dolphin Dr, St Augustine, FL 32080-4531 | 2007-06-26 |
1194943076 | Gregory Tarantola | Dentist | 559 W Twincourt Trl, 606, St Augustine, FL 32095-8805 | 2007-04-23 |
1407966542 | Henry James Tabeling | Dentist | 117 Saint Andrews Place Dr, St Augustine, FL 32092-0774 | 2006-08-30 |
Find all providers in ST AUGUSTINE |
City | ST AUGUSTINE |
Zip Code | 32086 |
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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.