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Deactivated NPI 1053482166 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Jacob Gordon , DDS

Dentist - General Practice • Malden, MA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robert Gordon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 11, 2006
NPI Deactivation Date February 17, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Gordon, DDS was a registered Dentist - General Practice practicing in Malden, MA. Throughout an active medical career spanning 17 years, Dr. Gordon provided care at the practice location at 10 HOLDEN ST until profile deactivation on 2023-02-17.

Practice Location & Contact Primary Location

Practice Address

10 Holden St
Suite 3b

Malden, MA 021485238

Telephone 7813228558
Fax 7812880008
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Malden, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
31 Specialists

Practicing in Malden, MA (3722 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MA 9804

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
Dr. Christine Melito , DMD

Dentist - Endodontics

NPI 1407946718

Doctor of Dental Medicine

NPI 1598832230

LICAC

NPI 1861551103

LICAC

Dr. Jacinta Fernandes , DDS

Dentist - Endodontics

NPI 1881751972

Doctor of Dental Surgery

Dr. Tom Ho , DMD

Dentist - General Practice

NPI 1881787141

Doctor of Dental Medicine

Stephen Li , LIC AC

Acupuncturist

NPI 1982916177

LICAC

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 17, 2023

Record deactivated on February 17, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 10 HOLDEN ST, SUITE 3B, MALDEN, MA 021485238 (Tel: 7813228558)

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Updated Business Mailing Address July 08, 2007

Registered at 10 HOLDEN ST, SUITE 3B, MALDEN, MA 021485238 (Tel: 7813228558)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT GORDON, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #9804 in MA)

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Initial NPI Registration & Enumeration November 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1053482166
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 11, 2006
Last Update: July 08, 2007
Deactivation Date: February 17, 2023

Mailing Address

10 Holden St, Suite 3b

Malden, MA 021485238

Phone: 7813228558

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.