Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396734331 Individual Practitioner Male Practitioner

Dr. Mark Howard Gordon , DDS

Dentist - General Practice • Valley Stream, NY

Professional Overview & Biography Verified Profile Summary

Dr. Mark Gordon, DDS is a registered healthcare professional specializing in Dentist - General Practice in Valley Stream, NY. Practice services are available at 15 FLETCHER AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

15 Fletcher Ave

Valley Stream, NY 115804000

Telephone 5165611577
Fax 5165611577
Associated Practice Facility / Clinic
🏢 Li Premier Medical Care Pllc Facility NPI 1245575448

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Valley Stream, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
25 Specialists

Practicing in Valley Stream, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 036092

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
00717506 (NY)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Dr. Roman Urbanczyk , MD

Internal Medicine

NPI 1114933918

Doctor of Medicine (M.D.)

NPI 1578670196

Doctor of Chiropractic

NPI 1588726715

Doctor of Medicine (M.D.), Doctor of Osteopathic Medicine (D.O.)

NPI 1679635833

Doctor of Medicine (M.D.), Doctor of Osteopathic Medicine (D.O.)

Dr. Dolores Brandt , PhD

Psychologist - Clinical

NPI 1710080502

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 15 FLETCHER AVE, VALLEY STREAM, NY 115804000 (Tel: 5165611577)

📍
Updated Business Mailing Address July 08, 2007

Registered at 15 FLETCHER AVE, VALLEY STREAM, NY 115804000 (Tel: 5165611577)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as MARK GORDON, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #036092 in NY)

🟢
Initial NPI Registration & Enumeration October 20, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396734331
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 20, 2005
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

15 Fletcher Ave

Valley Stream, NY 115804000

Phone: 5165611577

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.