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Active NPI 1598285538 Individual Practitioner Female Practitioner

Olivia Mcdaniel Van Gordon

Dentist - General Practice • Grenada, MS

Professional Overview & Biography Verified Profile Summary

Olivia Van Gordon is a registered healthcare professional specializing in Dentist - General Practice in Grenada, MS. Practice services are available at 1800 F S HILL DR STE A under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1800 F S Hill Dr Ste A

Grenada, MS 389015071

Telephone 6622261757
Fax 6623072709
Associated Practice Facility / Clinic
🏢 Grenada Dental Clinic Pllc Facility NPI 1851886857

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Grenada, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.3 Yrs
Regional Practice Density
8 Specialists

Practicing in Grenada, MS (895 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 MS 3934-17

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

1 Associated Practitioners
Dr. Esaias Richardson , DDS

Dentist - General Practice

NPI 1518981844

Doctor of Dental Surgery

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active June 21, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location June 21, 2017

Registered at 1800 F S HILL DR STE A, GRENADA, MS 389015071 (Tel: (662) 226-1757)

📍
Updated Business Mailing Address June 21, 2017

Registered at 1800 F S HILL DR STE A, GRENADA, MS 389015071 (Tel: 6622261757)

👤
Provider Name / Credentials Updated June 21, 2017

Recorded as OLIVIA VAN GORDON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 21, 2017

Dentist (License #3934-17 in MS)

🟢
Initial NPI Registration & Enumeration June 21, 2017

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: 1598285538
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 21, 2017
Last Update: July 21, 2022
Sole Proprietor: Yes

Mailing Address

1800 F S Hill Dr Ste A

Grenada, MS 389015071

Phone: 6622261757

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.