{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ANDRIANETTE GORDON DDS PLLC",
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"FirstName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "106 PROSPECT AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BUFFALO",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "14201-2358",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "585-208-0639",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2809 WEHRLE DR STE 11",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WILLIAMSVILLE",
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"PracticeLocationAddressTelephoneNumber": "585-208-0639",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/26/2025",
"LastUpdateDate": "12/26/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GORDON",
"AuthorizedOfficialFirstName": "ANDRIANETTE",
"AuthorizedOfficialMiddleName": "NICOLE",
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"AuthorizedOfficialCredential": "DDS",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD0000X",
"TaxonomyName": "Dental Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}