Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1679571616 Deactivated / Inactive NPI Male Practitioner

Dr. Larry R Van Gordon , DMD

Dentist - General Practice • Aloha, OR

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

Registration / Start Date July 13, 2005
NPI Deactivation Date March 25, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Larry Van Gordon, DMD was a registered Dentist - General Practice practicing in Aloha, OR. Throughout an active medical career spanning 1 years, Dr. Van Gordon provided care at the practice location at 3895 SW 185TH AVE until profile deactivation on 2006-03-25.

Practice Location & Contact Primary Location

Practice Address

3895 Sw 185th Ave
Ste 110

Aloha, OR 970071573

Telephone 5036491646
Associated Practice Facility / Clinic
🏢 Ernest R Thompson Dmd Pc Facility NPI 1548376858

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Aloha, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 13.7 Yrs
Regional Practice Density
15 Specialists

Practicing in Aloha, OR (1994 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 OR 4372

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

2 Associated Practitioners
Dr. Ernest Thompson , DMD

Dentist - General Practice

NPI 1477597292

Doctor of Dental Medicine

NPI 1629078167

Doctor of Dental Medicine

Career & Practice History Timeline

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

8 Historical Events
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NPI Profile Deactivated August 24, 2017

Record deactivated on August 24, 2017

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NPI Profile Reactivated November 10, 2008

Record officially reactivated for active practice on November 10, 2008

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Updated Practice Location November 10, 2008

Registered at 3895 SW 185TH AVE, STE 110, ALOHA, OR 970071573 (Tel: 5036491646)

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Updated Business Mailing Address November 10, 2008

Registered at 3895 SW 185TH AVE, STE 110, ALOHA, OR 97007 (Tel: 5036491646)

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Provider Name / Credentials Updated November 10, 2008

Recorded as LARRY VAN GORDON, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 10, 2008

Dentist (License #4372 in OR)

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NPI Profile Deactivated March 25, 2006

Record deactivated on March 25, 2006

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Initial NPI Registration & Enumeration July 13, 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: 1679571616
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2005
Last Update: November 10, 2008
Deactivation Date: March 25, 2006

Mailing Address

3895 Sw 185th Ave, Ste 110

Aloha, OR 97007

Phone: 5036491646

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.