Individual provider Active NPI

John Gordon, D.D.S.

  • Dentist
  • Islip Terrace, NY
National Provider Identifier
1801999719
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
044635 Issued in NY
Practice address
111 Carleton Ave
Suite 1
Islip Terrace, NY 11752-2236
Phone
(631) 581-3500
Fax
(631) 581-4723
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 044635 NY
Dentist 122300000X 044635 NY Primary
Durable Medical Equipment & Medical Supplies 332B00000X 044635 NY

Addresses

Primary practice location

111 Carleton Ave
Suite 1
Islip Terrace, NY 11752-2236

Mailing address

111 Carleton Ave Ste 1
Islip Terrace, NY 11752-2236
Phone (631) 581-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
044635NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleeping and Snoring Solutions of Long Island Durable Medical Equipment & Medical Supplies Current Accepting new patients
John T Gordon D.D.S., P.C. Past Accepting new patients

Locations

111 Carleton Ave
Ste 1
Islip Terrace, NY 11752
Phone (631) 581-3500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1801999719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CARLETON AVE STE 1",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117522236",
            "telephone_number": "631-581-3500",
            "fax_number": "631-581-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CARLETON AVE",
            "address_2": "SUITE 1",
            "city": "ISLIP TERRACE",
            "state": "NY",
            "postal_code": "117522236",
            "telephone_number": "631-581-3500",
            "fax_number": "631-581-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NY",
            "license": "044635",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "044635",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "044635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Islip Terrace, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.