1770659542 NPI number — DR. MARSHA ADLER GORDON DDS

Table of content: DR. MARSHA ADLER GORDON DDS (NPI 1770659542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770659542 NPI number — DR. MARSHA ADLER GORDON DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GORDON
Provider First Name:
MARSHA
Provider Middle Name:
ADLER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770659542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1525 HAUSMAN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18104-9258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-433-5111
Provider Business Mailing Address Fax Number:
610-433-4393

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1525 HAUSMAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-9258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-433-5111
Provider Business Practice Location Address Fax Number:
610-433-4393
Provider Enumeration Date:
11/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223P0221X , with the licence number:  DS026384L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 51022 . This is a "DELTA DENTAL OF DE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: CDMN1 . This is a "DELTA DENTAL OF MN" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 05030 . This is a "DELTA DENTAL OF IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 11198 . This is a "DELTA DENTAL OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 23166 . This is a "DELTA DENTAL OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 84056 . This is a "DELTA DENTAL OF CO" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: CDOH1 . This is a "DELTA DENTAL OF OH" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: CDTN1 . This is a "DELTA DENTAL OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 39069 . This is a "DELTA DENTAL OF WI" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 54084 . This is a "DELTA DENTAL OF VA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 91062 . This is a "DELTA DENTAL OF WA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: CDM10 . This is a "DELTA DENTAL OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 02027 . This is a "DELTA DENTAL OF VT" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 05029 . This is a "DELTA DENTAL OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 56101 . This is a "DELTA DENTAL OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 86027 . This is a "DELTA DENTAL OF AR" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: CDKS1 . This is a "DELTA DENTAL OF KS" identifier , issued by the state of ( KS ) . This identifiers is of the category "OTHER".
  • Identifier: CDOK1 . This is a "DELTA DENTAL OF OK" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 04614 . This is a "DELTA DENTAL OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 22189 . This is a "DELTA DENTAL OF CT" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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