Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114072345 Individual Practitioner Male Practitioner

Dr. Michael Jay Gordon , DDS

Dentist - General Practice • Fayetteville, NC

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Dr. Michael Gordon, DDS is a registered healthcare professional specializing in Dentist - General Practice in Fayetteville, NC. Official NPI practice address is registered at 4155 FERNCREEK DR.

Practice Location & Contact Primary Location

Practice Address

4155 Ferncreek Dr
Suite 101

Fayetteville, NC 283142581

Telephone 9103238899
Fax 9104866524
Associated Practice Facility / Clinic
🏢 Pembroke Drug Center Facility NPI 1720173396

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Fayetteville, NC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 27.0 Yrs
State Avg: 11.6 Yrs
Regional Practice Density
105 Specialists

Practicing in Fayetteville, NC (4047 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 NC 5492

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Ucci
805329 (NC)
Commercial Insurance / Payer ID Delta Retired
5492 (NC)

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1902896335

Doctor of Dental Medicine

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 4155 FERNCREEK DR, SUITE 101, FAYETTEVILLE, NC 283142581 (Tel: 9103238899)

📍
Updated Business Mailing Address July 08, 2007

Registered at 4325 NORWICK DR, FAYETTEVILLE, NC 283142531 (Tel: 9103238899)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL GORDON, DDS

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

Dentist (License #5492 in NC)

🟢
Initial NPI Registration & Enumeration January 25, 2007

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: 1114072345
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 25, 2007
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

4325 Norwick Dr

Fayetteville, NC 283142531

Phone: 9103238899

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.