MEDICARE: DR. JOHN GORDON D.D.S.

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	332BC3200X	Customized Equipment (DME)	044635	NY
2	122300000X	Dentist	044635	NY
3	332B00000X	Durable Medical Equipment & Medical Supplies	044635	NY

General Provider Information

NPI Number	:	1801999719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN GORDON D.D.S.

Provider Business Mailing Address
First Line	:	111 CARLETON AVE STE 1
Second Line	:
City	:	ISLIP TERRACE
State	:	NY
Zip	:	11752-2236
Country	:	US
Telephone Number	:	631-581-3500
Fax Number	:	631-581-4723

Provider Business Practice Location Address
First Line	:	111 CARLETON AVE
Second Line	:	SUITE 1
City	:	ISLIP TERRACE
State	:	NY
Zip	:	11752-2236
Country	:	US
Telephone Number	:	631-581-3500
Fax Number	:	631-581-4723

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	03/04/2026

Similar Medicare Providers

1235003716 — SLEEPING AND SNORING SOLUTIONS OF LONG ISLAND
Practice Location Address:

111 CARLETON AVE
ISLIP TERRACE, NY
11752-2236

Practice Phone: 631-581-3500
Practice Fax: 631-581-4723

1396730578 — MR. PRAKASH M PARIKH MD
Practice Location Address:

111 CARLETON AVE , SUITE 6
ISLIP TERRACE, NY
11752-2236

Practice Phone: 631-581-0300
Practice Fax: 631-581-2619

1205821485 — MR. SURYAKANT B PARIKH MD
Practice Location Address:

111 CARLETON AVE , SUITE 6
ISLIP TERRACE, NY
11752-2236

Practice Phone: 631-581-0300
Practice Fax: 631-581-2619

1518952100 — DR. PETER CUTLER D.P.M.
Practice Location Address:

111 CARLETON AVE , SUITE 5
ISLIP TERRACE, NY
11752-2236

Practice Phone: 631-581-8822
Practice Fax: 631-581-0857

1790882983 — SUFFOLK PODIATRY PC
Practice Location Address:

111 CARLETON AVE , SUITE 5
ISLIP TERRACE, NY
11752-2236

Practice Phone: 631-581-8822
Practice Fax: 631-581-0857

1164578019 — DR. JOSEPH MICHAEL DELAGERA JR. DDS
Practice Location Address:

111 CARLETON AVE , SUITE 1
ISLIP TERRACE, NY
11752-2236

Practice Phone: 631-581-3500
Practice Fax: 631-581-4723

Directions to “ DR. JOHN GORDON D.D.S.” 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.