Dustin Joel Gordon, PH.D.
NPI 1124126404ActiveIndividual· Clinical Neuropsychologist· Ridgwood, NJ
Clinical Neuropsychologist (PH.D.) with Vdb Enterprises LLC, practicing in Ridgwood, New Jersey. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1124126404 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | Yes |
| NPI issued | Sep 20, 2006 |
| Last updated in NPPES | Jul 8, 2007 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinical Neuropsychologist Primary | 103G00000X | 3610 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (NJ) |
|---|
Education and affiliations
| Graduation year | 1996 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- Vdb Enterprises LLCFair Lawn, NJ · 3 clinicians