Provider Demographics
NPI:1649662248
Name:SOKOLOFF, GORDON D (DDS)
Entity type:Individual
Prefix:
First Name:GORDON
Middle Name:D
Last Name:SOKOLOFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MIRACLE MILE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-567-1992
Mailing Address - Fax:305-567-9598
Practice Address - Street 1:220 MIRACLE MILE
Practice Address - Street 2:SUITE 228
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-567-1992
Practice Address - Fax:305-567-9598
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN9327122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist