Healthcare Provider Details

I. General information

NPI: 1679963268
Provider Name (Legal Business Name): HOWARD A. GORDON, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2015
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 N STATE RD SUITE 201
BRIARCLIFF MANOR NY
10510-1477
US

IV. Provider business mailing address

449 N STATE RD STE 201
BRIARCLIFF MANOR NY
10510-1478
US

V. Phone/Fax

Practice location:
  • Phone: 914-762-8888
  • Fax: 914-762-8916
Mailing address:
  • Phone: 914-762-8888
  • Fax: 914-762-8916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number034103
License Number StateNY

VIII. Authorized Official

Name: HOWARD A GORDON
Title or Position: OWNER
Credential: D.D.S.
Phone: 914-762-8888