Dental Center of Goshen PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DENTAL CENTER OF GOSHEN PLLC

Practice address

4024 Elkhart Rd
Goshen, IN 46526-5807

Phone

(574) 534-7577

NPI assigned

Dec 9, 2011

Organization subpart

No

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

Authorized official

Name

Mike Cole

Title

Insurance Director

Phone

(727) 726-1611

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323388800000",
    "number": "1013285766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4024 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465265807",
            "telephone_number": "574-534-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CENTER OF GOSHEN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-09",
        "last_updated": "2011-12-09",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "INSURANCE DIRECTOR",
        "authorized_official_telephone_number": "727-726-1611"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Del Real, BSW
• Kaitlyn E Delgado, FNP-BC
• Victoria Delgado
• Peter M Delneky, MD
• Michael Glen Delucenay
• Michael S. Deranek, MSW, LSW, CSAYP
• Susan Kay Derrickson, NP-BC
• Carol A Derucki, LMHC
• Sarah Detro
• Aaron Blaine Detwiler, MSW, LCSW

• Dentist in Goshen, IN
• Providers in Goshen, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2011; 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.