Joe Gordon is a Pediatric Dentistry in Lake Forest, Illinois. Joe Gordon practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Joe Gordon is 1124199468. The last update date is 2007-07-08.
Joe Gordon's current location address is 514 N Western Ave, Lake Forest, Illinois. You can contact this provider via phone number 8474821900 and fax number 8474821909. The mailing address for Joe Gordon is 514 N Western Ave, Lake Forest, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joe Gordon |
|---|---|
| Address | 514 N Western Ave, Lake Forest, Illinois |
| Phone Number | 8474821900 |
| Fax Number | 8474821909 |
| Sole Proprietor | Y |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1124199468 |
|---|---|
| Provider Enumeration Date | 2006-11-10 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 514 N Western Ave |
|---|---|
| City | Lake Forest |
| State | Illinois (IL) |
| Post Code | 600451989 |
| Phone Number | 8474821900 |
| Fax Number | 8474821909 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Joe Gordon by the Centers for Medicare & Medicaid Services?
The Joe Gordon has been issued the NPI (National Provider Identifier) 1124199468, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Joe Gordon is physically located?
The Joe Gordon is situated at the following address: 514 N Western Ave, Lake Forest, IL 600451989.
What is Joe Gordon's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Joe Gordon's specialized field of practice is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this area of specialization is 1223P0221X.
On what date was the 1124199468 assigned to Joe Gordon?
The Joe Gordon was issued its 1124199468 on 2006-11-10, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Joe Gordon most recently updated or revised?
The details related to Joe Gordon, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.
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