Individual
GORDON WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
20726 NORTHERN BLVD STE 2B, BAYSIDE, NY 11361-3147
(718) 885-4323
Mailing address
20726 NORTHERN BLVD STE 2B, BAYSIDE, NY 11361-3147
(718) 885-4323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
057309
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2013
Last updated
01/16/2026
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