Provider Demographics
NPI:1265221139
Name:POON, GORDON (DDS)
Entity type:Individual
Prefix:MR
First Name:GORDON
Middle Name:
Last Name:POON
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 OAK KNOLLS CRESCENT
Mailing Address - Street 2:
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M1B4V4
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1899 BROCK ROAD
Practice Address - Street 2:23
Practice Address - City:PICKERING
Practice Address - State:ONTARIO
Practice Address - Zip Code:L1V4H7
Practice Address - Country:CA
Practice Address - Phone:905-683-8879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ1505631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice