Dillon Goolsby, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14735 Issued in MN

Practice address

429 Commerce Dr Ste 400
Woodbury, MN 55125-4953

Phone

(651) 731-2342

NPI assigned

Feb 2, 2022

Last updated

Jun 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Northland Dental Partners, PLLC

  dba Metro Dentalcare Woodbury

  • General Practice Dentistry
  • Woodbury, MN
  • NPI 1891443263
  NPD

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656115200000",
    "number": "1013660646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 COMMERCE DR STE 400",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254953",
            "telephone_number": "651-788-0812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 COMMERCE DR STE 400",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254953",
            "telephone_number": "651-731-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOLSBY",
        "first_name": "DILLON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-02",
        "last_updated": "2022-06-25",
        "certification_date": "2022-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip J Gonzales, MD
• Monia Ensequia Gonzalez
• Yvonne Grace Gonzalez
• Brittany Goodmanson
• Jeanne Mackenzie Goodspeed, MD
• Meijie Chen Goudy, CCC-SLP
• Jasmine Star Grabau
• Pamela Lynn Graber, LMFT
• Grace and Renewal LLC
• Graceful Living Home Care LLC

• General Practice Dentistry in Woodbury, MN
• Providers in Woodbury, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2022; 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.