Dr. Larry R Van Gordon , DMD
Dentist - General Practice • Aloha, OR
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.
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
3895 Sw 185th Ave
Ste 110
Aloha, OR 970071573
Specialty Benchmarks & Practice Insights
Comparative analytics for Dentist - General Practice in Aloha, OR
Practicing in Aloha, OR (1994 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 1223G0001X
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
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Dentist - General Practice
Doctor of Dental Medicine
Dentist
Doctor of Dental Medicine
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on August 24, 2017
Record officially reactivated for active practice on November 10, 2008
Registered at 3895 SW 185TH AVE, STE 110, ALOHA, OR 970071573 (Tel: 5036491646)
Registered at 3895 SW 185TH AVE, STE 110, ALOHA, OR 97007 (Tel: 5036491646)
Recorded as LARRY VAN GORDON, DMD
Dentist (License #4372 in OR)
Record deactivated on March 25, 2006
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
3895 Sw 185th Ave, Ste 110
Aloha, OR 97007
Phone: 5036491646
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