DR. JASON M GORDON DDS
NPI 1801455597
Dentist in Salt Lake City, UT

Active since June 06, 2019PECOS Enrolled
1963 S 1200 E STE 103, SALT LAKE CITY, UT 84105(801) 466-1212 Get Directions Write a Review

NPPES record last updated: June 9, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 9, 2020, Jun 6, 2019 (2 updates tracked since 2019).

About Dr. Jason M Gordon Dds NPPES

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

DR. JASON M GORDON DDS (NPI 1801455597) is an individual dentist in Salt Lake City, Utah, licensed in Utah (11313905-9922) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801455597
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. JASON M GORDONCredential: DDS
Location Address1963 S 1200 E STE 103Salt Lake City, UT 84105-3523
Mailing Address4577 S 4000 W Ste BWest Valley, UT 84120-6222 · (801) 895-2788
Sole ProprietorNo
Enumeration DateJune 6, 2019
Last NPPES UpdateJune 9, 20202 updates tracked since enumeration
NPPES CertifiedJune 9, 2020
NPI 1801455597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License Licensed in UT · 11313905-9922
Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

1963 S 1200 E STE 103, Salt Lake City, UT 84105

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Dr. Jason M Gordon Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84105 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
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 3

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

Dentist (General Practice)
1963 S 1200 E STE 103
SALT LAKE CITY, UT 84105
Dentist
1963 S 1200 E STE 103
SALT LAKE CITY, UT 84105
Dentist (General Practice)
1963 S 1200 E STE 103
SALT LAKE CITY, UT 84105

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1801455597, enumerated as an "individual" on June 06, 2019.

The provider is located at 1963 S 1200 E STE 103 SALT LAKE CITY, UT 84105 and the phone number is (801) 466-1212.

Dentist with taxonomy code 122300000X.

The provider might be accepting Accepts: BEST Life, Blue Cross and Blue Shield of Montana,. Please consult your insurance carrier or call the provider to verify.