Organization Active NPI

Goldberg Dental of Valley Stream PC

  • Dentist
  • Valley Stream, NY
National Provider Identifier
1003935040
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0318241 Issued in NY
Legal business name
GOLDBERG DENTAL OF VALLEY STREAM PC
Practice address
417 West Merrick Road
Valley Stream, NY 11580
Phone
(516) 568-0448
Fax
(516) 561-3024
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Steven M Goldberg, DDS
Title
Pres
Phone
51655680448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0318241 NY Primary

Addresses

Primary practice location

417 West Merrick Road
Valley Stream, NY 11580

Mailing address

417 West Merrick Road
Valley Stream, NY 11580
Phone (516) 568-0448

National Provider Directory

National Provider Directory

Locations

417 W Merrick Rd
Valley Stream, NY 11580
Phone (516) 561-4060

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003935040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 WEST MERRICK ROAD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-568-0448",
            "fax_number": "516-561-3024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 WEST MERRICK ROAD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "11580",
            "telephone_number": "516-568-0448",
            "fax_number": "516-561-3024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDBERG DENTAL OF VALLEY STREAM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "51655680448",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "0318241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.