Provider Demographics
NPI:1821204280
Name:DON C GORDY, DDS PA
Entity Type:Organization
Organization Name:DON C GORDY, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:C
Authorized Official - Last Name:GORDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, PA
Authorized Official - Phone:785-267-3855
Mailing Address - Street 1:3345 SW FAIRLAWN RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-3968
Mailing Address - Country:US
Mailing Address - Phone:785-267-3855
Mailing Address - Fax:785-267-3857
Practice Address - Street 1:3345 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-3968
Practice Address - Country:US
Practice Address - Phone:785-267-3855
Practice Address - Fax:785-267-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS52651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty