Healthcare Provider Details

I. General information

NPI: 1396656906
Provider Name (Legal Business Name): GARYNADLERDDSPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 DAVISON AVE
OCEANSIDE NY
11572-2236
US

IV. Provider business mailing address

129 DAVISON AVE
OCEANSIDE NY
11572-2236
US

V. Phone/Fax

Practice location:
  • Phone: 516-763-5683
  • Fax: 516-763-5684
Mailing address:
  • Phone: 516-763-5683
  • Fax: 516-763-5684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY NADLER
Title or Position: PRESIDENT
Credential: DDS
Phone: 516-763-5683