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DR. GORDON LEE PATTISON III D.D.S.
NPI 1124351358
Dentist - Periodontics in Los Angeles, CA

Active since September 04, 2009Opted out of Medicare · through Feb 11, 2028
11859 WILSHIRE BLVD, STE. 550, LOS ANGELES, CA 90025(310) 473-3800(310) 473-9107 Get Directions Write a Review

NPPES record last updated: September 4, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Gordon Lee Pattison Iii D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. GORDON LEE PATTISON III D.D.S. (NPI 1124351358) is an individual periodontics provider in Los Angeles, California, licensed in California (22399) and active in the NPI registry since September 2009. He has opted out of Medicare through February 11, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124351358
Entity TypeIndividualMale
Primary Taxonomy1223P0300X
Provider Legal NameDR. GORDON LEE PATTISON IIICredential: D.D.S.
Location Address11859 WILSHIRE BLVD, STE. 550Los Angeles, CA 90025-6616
Mailing Address11859 Wilshire Blvd, Ste. 550Los Angeles, CA 90025-6616 · (310) 473-3800 · Fax (310) 473-9107
Phone(310) 473-3800
Fax(310) 473-9107
Sole ProprietorYes
Enumeration DateSeptember 4, 2009
✔ NPI 1124351358 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · PeriodonticsDental Providers
Taxonomy Code1223P0300X
License✔ Licensed in CA · 22399
Definition
That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
11859 WILSHIRE BLVD, Los Angeles, CA 90025
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Gordon Lee Pattison Iii D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 11, 2020 through February 11, 2028.

Opt-Out Effective DateFebruary 11, 2020
Opt-Out In Effect ThroughFebruary 11, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90025 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEART CHECK LOS ANGELES, LLC
Technician, Other
11859 WILSHIRE BLVD, SUITE 110
LOS ANGELES, CA 90025
Los Angeles County (310) 479-2211
DR. CHARLES S. HAND D.D.S.
Dentist (General Practice)
11859 WILSHIRE BLVD, SUITE 680
LOS ANGELES, CA 90025
Los Angeles County (310) 575-1996
DAVID DAVOODPOUR D.D.S.
Dentist (General Practice)
11859 WILSHIRE BLVD, SUITE 660
LOS ANGELES, CA 90025
Los Angeles County (310) 477-4214
GORDON L. PATTISON, D.D.S., APDC
Dentist (Periodontics)
11859 WILSHIRE BLVD, STE. 550
LOS ANGELES, CA 90025
Los Angeles County (310) 473-3800

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gordon Pattison's NPI number?

The NPI number for Gordon Pattison is 1124351358. It was assigned to this individual provider in the NPPES registry on September 4, 2009.

Where is Gordon Pattison located?

Gordon Pattison practices at 11859 Wilshire Blvd Ste. 550, Los Angeles, CA 90025. The listed phone number is (310) 473-3800.

What is Gordon Pattison's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.

Is Gordon Pattison enrolled in Medicare?

No. Gordon Pattison has opted out of Medicare through February 11, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Gordon Pattison was last updated on September 4, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.