BROCK A VAN GORDON DMD, PC; NPI #1063242691

Contact Information

BROCK A VAN GORDON DMD, PC

6485 SW BORLAND RD STE G
TUALATIN, OR 97062-9762

Phone: 503-878-4163
Fax: 833-438-7620
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Sleep Disorder Diagnostic	261QS1200X
Dental	261QD0000X

Indicates primary specialty

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NPI Profile & details for BROCK A VAN GORDON DMD, PC

NPI Number	`1063242691`
LBN Legal business name	BROCK A VAN GORDON DMD, PC
Authorized official	BROCK VAN GORDON - (OWNER/ DENTIST)
Entity	Organization
Organization subpart ¹	No
Enumeration date	08/07/2024
Last updated	07/11/2025 - About 11 months ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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