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Deactivated NPI 1407851702 Deactivated / Inactive NPI Male Practitioner

Dr. Michael Lewis Gordon , DMD

Dentist - Pediatric Dentistry • Cincinnati, OH

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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. Michael Gordon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 15, 2005
NPI Deactivation Date March 17, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Michael Gordon, DMD was a registered Dentist - Pediatric Dentistry practicing in Cincinnati, OH. Throughout an active medical career spanning 1 years, Dr. Gordon provided care at the practice location at 3544 SPRINGDALE RD until profile deactivation on 2006-03-17.

Practice Location & Contact Primary Location

Practice Address

3544 Springdale Rd

Cincinnati, OH 452511331

Telephone 5133856555
Fax 5133852833
Associated Practice Facility / Clinic
🏢 Michael L Gordon Dmd Inc Facility NPI 1164694311

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Pediatric Dentistry in Cincinnati, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 5.0 Yrs
State Avg: 6.8 Yrs
Regional Practice Density
47 Specialists

Practicing in Cincinnati, OH (331 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 - Pediatric Dentistry Primary Specialty

NUCC Taxonomy Code: 1223P0221X

State License OH 30014084

An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
0215565 (OH)

Career & Practice History Timeline

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

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 3544 SPRINGDALE RD, CINCINNATI, OH 452511331 (Tel: 5133856555)

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Updated Business Mailing Address July 08, 2007

Registered at 3544 SPRINGDALE RD, CINCINNATI, OH 452511331 (Tel: 5133856555)

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Provider Name / Credentials Updated July 08, 2007

Recorded as MICHAEL GORDON, D.M.D.

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

Dentist (License #30014084 in OH)

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NPI Profile Reactivated April 03, 2006

Record officially reactivated for active practice on April 03, 2006

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NPI Profile Deactivated March 17, 2006

Record deactivated on March 17, 2006

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Initial NPI Registration & Enumeration June 15, 2005

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: 1407851702
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 15, 2005
Last Update: June 28, 2026
Deactivation Date: March 17, 2006
Sole Proprietor: No

Mailing Address

3544 Springdale Rd

Cincinnati, OH 452511331

Phone: 5133856555

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.