Individual
DR. JOHN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
111 CARLETON AVE, SUITE 1, ISLIP TERRACE, NY 11752-2236
(631) 581-3500
(631) 581-4723
Mailing address
111 CARLETON AVE STE 1, ISLIP TERRACE, NY 11752-2236
(631) 581-3500
(631) 581-4723
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
044635
NY
332B00000X
Durable Medical Equipment & Medical Supplies
044635
NY
332BC3200X
Customized Equipment (DME)
044635
NY
Other
Enumeration date
09/06/2006
Last updated
03/04/2026
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