DR. JASON M GORDON (NPI# 1801455597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801455597 |
| Entity Type | Individual |
| Full Name | DR. JASON M GORDON |
| Credential | DDS |
| Practice Address |
1963 S 1200 E Ste 103 Salt Lake City UT 84105-3523 |
| Mailing Address |
4577 S 4000 W Ste B West Valley UT 84120-6222 |
| Practice Telephone | 8014661212 |
| Mailing Telephone | 8018952788 |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2020-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 11313905-9922 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588121776 | Jason Gordon | Acupuncturist | 205 E Rivo Alto Dr, Miami Beach, FL 33139-1247 | 2019-02-25 |
| 1114339553 | Jason Gordon | Counselor | 179 Davis Ave, Piscataway, NJ 08854-2467 | 2014-05-20 |
| 1174934764 | Jason Gordon | Social Worker | 1st Street Holloman Afb, Holloman Afb, NM 88330 | 2014-05-16 |
| 1326240458 | Jason R Gordon | Dentist | 724 Pelham Pkwy S, Bronx, NY 10462-1029 | 2007-06-01 |
| 1033641493 | Jason Gordon | Student in an Organized Health Care Education/Training Program | 108 E 96th St, Apt 5a, New York, NY 10128-6217 | 2017-04-03 |
| 1568902278 | Jason Gordon | Physical Therapist | 321 N Larchmont Blvd Ste 825, Los Angeles, CA 90004-6400 | 2017-02-28 |
| 1790132959 | Jason R Gordon | Emergency Medicine | 7435 W Talcott Ave, Chicago, IL 60631-3707 | 2016-05-18 |
| 1497915227 | Jason Gordon | Emergency Medicine | 100 Brewster Blvd, Naval Hospital, Camp Lejeune, NC 28547-2538 | 2008-06-16 |
| 1720245160 | Jason Gordon | Emergency Medicine | 3950 Austell Rd, Austell, GA 30106-1121 | 2008-05-22 |
| 1518024769 | Jason Gordon | Chiropractor | 162 W 56th St, Suite 205, New York, NY 10019-3831 | 2007-01-03 |
| Street Address |
1963 S 1200 E STE 103 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84105-3523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124438916 | Pdc Salt Lake City | Dentist | 1963 S 1200 E Ste 103, Salt Lake City, UT 84105-3523 | 2014-05-01 |
| 1538715982 | Pearce Robert Ollar | Dentist | 1963 S 1200 E Ste 103, Salt Lake City, UT 84105-3523 | 2019-08-12 |
| 1265883474 | Michael Blackhurst | Dentist | 1963 S 1200 E Ste 103, Salt Lake City, UT 84105-3523 | 2016-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285106237 | Laiyan H Bawadeen | Counselor | 1425 700 E Suite #102, Salt Lake City, UT 84105 | 2018-12-31 |
| 1639644255 | Claire Elizabeth Gray | Marriage & Family Therapist | 1425 700 East, Salt Lake City, UT 84105 | 2018-10-10 |
| 1083089643 | Celisa Packer | Social Worker | 2020 E Lake St, Salt Lake City, UT 84105 | 2015-12-08 |
| 1083052963 | Christina Elizabeth Burton | Nurse Practitioner | 1008 S 1100 E, Apt 6, Salt Lake City, UT 84105 | 2013-06-12 |
| 1649548355 | Leland Burt Cowan | Surgery | 1405 Princeton Ave, Salt Lake City, UT 84105 | 2011-12-08 |
| 1639460355 | Sally Cathleen Webster | Counselor | 1248 Yale Avenue, Salt Lake City, UT 84105 | 2011-04-28 |
| 1912205105 | Melissa Wilson | Case Manager/Care Coordinator | 1522 S 1100 E, Salt Lake City, UT 84105 | 2011-03-11 |
| 1013215789 | Tamara Marie Wright | Counselor | 1996 Lake St, Salt Lake City, UT 84105 | 2011-03-04 |
| 1144527243 | Crystal Nicole Garduno | Counselor | 1522 South 1100 East, Salt Lake City, UT 84105 | 2011-02-25 |
| 1508011180 | Keith Elliott | Anesthesiology | 1552 South 1000 East, Salt Lake City, UT 84105 | 2008-11-24 |
| Find all providers in zip 84105 | ||||
| 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 |
|---|---|---|---|---|
| 1295335404 | Ida Nourbakhsh | Dentist | 1947 E Redondo Ave, Salt Lake City, UT 84108-3119 | 2020-10-27 |
| 1538796818 | Andrew Phillips | Dentist | 2070 S View St Apt 113, Salt Lake City, UT 84105-3766 | 2020-03-25 |
| 1710450655 | Kelly D. Carroll D.d.s., PC | Dentist | 2114 E Fort Union Blvd, Salt Lake City, UT 84121-3142 | 2019-01-03 |
| 1730667031 | Hm Salt Lake | Dentist | 7138 S Highland Dr Ste 214, Salt Lake City, UT 84121-3783 | 2018-07-30 |
| 1316430721 | Kyle Perkins | Dentist | 268 W 400 S, Salt Lake City, UT 84101-1831 | 2018-06-11 |
| 1730634353 | Kyle J Baldwin | Dentist | 4046 S Highland Dr, Ste #113, Salt Lake City, UT 84124-1673 | 2016-08-24 |
| 1780047670 | Dane Parke Mullinax | Dentist | 831 S 700 E, Salt Lake City, UT 84102-3505 | 2016-03-30 |
| 1396105425 | Michael Lee Vanleeuwen | Dentist | 6936 S Promenade Dr Ste 201, Salt Lake City, UT 84121-3365 | 2016-03-02 |
| 1831555168 | Smile Dental Studio PC | Dentist | 1400 S Foothill Dr, Ste #36, Salt Lake City, UT 84108-2392 | 2015-12-31 |
| 1942697933 | Jennifer Rose | Dentist | 50 N Medical Dr, University Hospital, Salt Lake City, UT 84112 | 2015-04-17 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84105 |
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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.