DR. CHARLES G. GORDON (NPI# 1831164722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831164722 |
| Entity Type | Individual |
| Full Name | DR. CHARLES G. GORDON |
| Credential | D.D.S. |
| Practice Address |
1026 Eagleridge Blvd Pueblo CO 81008-2130 |
| Practice Telephone | 7193720808 |
| Mailing Telephone | 7193720808 |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2011-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
7308 | CO | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 02073088 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942692769 | Charles Gordon | Physical Therapist | 29 Center St Ste 1, Goffstown, NH 03045-2948 | 2015-03-03 |
| 1811019268 | Charles Thomas Gordon IIi | Psychiatry & Neurology | 11204 Farmland Dr, Rockville, MD 20852-4522 | 2007-04-05 |
| 1821103631 | Charles Albert Gordon | Physical Medicine & Rehabilitation | 1059 S Fairfax Ave, Los Angeles, CA 90019-4402 | 2006-08-20 |
| 1649243890 | Charles F Gordon | Anesthesiology | 9 Old Plank Rd Ste 100, Clifton Park, NY 12065-3107 | 2006-02-08 |
| 1326049529 | Charles Richard Gordon | Family Medicine | 200 Cabrini Blvd, Suite 17, New York, NY 10033-1100 | 2005-08-10 |
| 1750858700 | Charles Gordon | Case Manager/Care Coordinator | 4269 Pearl Rd, Cleveland, OH 44109-4234 | 2018-10-29 |
| 1134642655 | Charles Gordon | Nurse Anesthetist, Certified Registered | 3701 12th St N Ste 202, Saint Cloud, MN 56303-2253 | 2017-07-18 |
| 1114382025 | Charles Gordon Jr. | Physician Assistant | 315 S Manning Blvd, Albany, NY 12208-1707 | 2015-12-18 |
| 1275825135 | Charles Marvin Gordon Jr. | Orthopaedic Surgery | 1505 Daphne Ave, Daphne, AL 36526 | 2011-05-11 |
| 1841405743 | Charles Robert Gordon | Specialist/Technologist | 3910 Teays Valley Rd, Hurricane, WV 25526-9756 | 2007-05-14 |
| Street Address |
1026 EAGLERIDGE BLVD |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588112726 | Charles G Gordon Dds LLC | Dentist | 1026 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2016-09-16 |
| 1528458510 | Charles Ggordon Dds LLC | Dentist | 1026 Eagleridge Blvd, Pueblo, CO 81008-2130 | 2015-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396307849 | Elizabeth Lee Cochran | Dentist | 4130 Redwood Ln Unit 130, Pueblo, CO 81005-3292 | 2019-07-05 |
| 1154879344 | Pdsc PC | Dentist | 2041 Pepper Ln, Pueblo, CO 81005-3276 | 2016-09-15 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| 1558655928 | Sarah Elizabeth Keen | Dentist | 4104 Outlook Blvd, Pueblo, CO 81008-1670 | 2011-06-03 |
| 1861790792 | Andrew Comerci | Dentist | 1100 Eagleridge Blvd, Pueblo, CO 81008-2103 | 2011-03-01 |
| 1467756627 | Anthony G Oreskovich | Dentist | 1111 Pueblo Boulevard Way, Suite 140, Pueblo, CO 81005-1687 | 2011-01-03 |
| 1033356670 | Park West Dental PC | Dentist | 3470 Parker Blvd, Pueblo, CO 81003 | 2009-01-20 |
| 1942479761 | James Cover D.d.s., PC | Dentist | 2020 S Pueblo Blvd, Pueblo, CO 81005-2546 | 2008-02-26 |
| 1801064928 | Garbiso Dental Care Center | Dentist | 3210 Wedgewood Dr, Pueblo, CO 81005-2398 | 2008-02-11 |
| 1790963957 | Douglas L. Pearson | Dentist | 2225 Norman Ln, Pueblo, CO 81005-3357 | 2008-02-09 |
| Find all providers in PUEBLO | ||||
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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.