Healthcare Provider Details

I. General information

NPI: 1689567331
Provider Name (Legal Business Name): GIDON YONAH SHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W MERRICK RD
FREEPORT NY
11520-4144
US

IV. Provider business mailing address

14437 72ND AVE
FLUSHING NY
11367-2401
US

V. Phone/Fax

Practice location:
  • Phone: 929-365-3472
  • Fax:
Mailing address:
  • Phone: 929-365-3472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number065559
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: