MEDICARE: GORDON WANG DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	057309	NY
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1750624458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON WANG DDS

Provider Business Mailing Address
First Line	:	20726 NORTHERN BLVD STE 2B
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3147
Country	:	US
Telephone Number	:	718-885-4323
Fax Number	:

Provider Business Practice Location Address
First Line	:	20726 NORTHERN BLVD STE 2B
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-3147
Country	:	US
Telephone Number	:	718-885-4323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2013
Last Update Date	:	01/16/2026

Similar Medicare Providers

1386467512 — GW DENTAL STUDIO PC
Practice Location Address:

20726 NORTHERN BLVD STE 2B
BAYSIDE, NY
11361-3147

Practice Phone: 718-885-4323
Practice Fax: 718-885-4325

1043672595 — JACKLYN MARIE IANNITTI OTR/L
Practice Location Address:

3436 BELL BLVD
BAYSIDE, NY
11361-2375

Practice Phone: 917-574-5415
Practice Fax:

1912864331 — ESSENCE OF BEAUTY MED SPA
Practice Location Address:

3850 BELL BLVD , SUITE A2
BAYSIDE, NY
11361

Practice Phone: 718-589-4541
Practice Fax: 718-893-8511

1184582132 — ROWEN KIRRON FREDERICK FNP
Practice Location Address:

21304 NORTHERN BLVD
BAYSIDE, NY
11361-3344

Practice Phone: 929-744-1197
Practice Fax:

1770580235 — YEAHSEON CHOI BRUININGS MD
Practice Location Address:

3438 BELL BLVD , PH FLOOR 5
BAYSIDE, NY
11361-1730

Practice Phone: 718-360-5768
Practice Fax: 718-224-5885

1174522726 — DR. JEFFREY KRUPEN M.D.
Practice Location Address:

21432 43RD AVE
BAYSIDE, NY
11361-2956

Practice Phone: 718-224-7200
Practice Fax: 718-224-7582

Directions to “ GORDON WANG DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.