Healthcare Provider Details

I. General information

NPI: 1740270677
Provider Name (Legal Business Name): GARY NADLER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2005
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 PARK AVE
OCEANSIDE NY
11572-4340
US

IV. Provider business mailing address

3510 PARK AVE
OCEANSIDE NY
11572-4340
US

V. Phone/Fax

Practice location:
  • Phone: 516-448-1582
  • Fax:
Mailing address:
  • Phone: 516-448-1582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number039376
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: