Provider Demographics
NPI:1538410477
Name:GORDON, NICHOLAS BARRINGTON (DMD)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:BARRINGTON
Last Name:GORDON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:4710 AUTH PL STE 490
Mailing Address - Street 2:
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746-4212
Mailing Address - Country:US
Mailing Address - Phone:301-423-0264
Mailing Address - Fax:301-423-2572
Practice Address - Street 1:4710 AUTH PL STE 490
Practice Address - Street 2:
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20746-4212
Practice Address - Country:US
Practice Address - Phone:301-423-0264
Practice Address - Fax:301-423-2572
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2020-06-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MD164661223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty