DR. GORDON MATHEW CALLISON D.D.S. NPI 1053412718

NPI Information

NPI: 1053412718
Provider Name: DR. GORDON MATHEW CALLISON, D.D.S.
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

Address:
820 S DAMEN AVE
JESSE BROWN VAMC DENTAL SERVICE
CHICAGO, IL
ZIP 60612
Phone: (312) 569-6669
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DR. Gordon Mathew Callison, D.D.S. is a prosthodontics dentist in Chicago, IL. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DR. Gordon Mathew Callison, D.D.S. NPI is 1053412718. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

820 S DAMEN AVE
JESSE BROWN VAMC DENTAL SERVICE
CHICAGO, IL
ZIP 60612-728
Phone: (312) 569-6669
Fax: (312) 569-8089

The enumeration date for this NPI number is 9/26/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223P0700X	Dentist	Prosthodontics		ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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