Gary Golovan, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

18509 Issued in OH

Practice address

28790 Chagrin Blvd
Suite # 250
Woodmere, OH 44122-4638

Phone

(216) 591-1916

Fax

(216) 591-0835

NPI assigned

Oct 18, 2007

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1033308754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28790 CHAGRIN BLVD",
            "address_2": "SUITE # 250",
            "city": "WOODMERE",
            "state": "OH",
            "postal_code": "441224638",
            "telephone_number": "216-591-1916",
            "fax_number": "216-591-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28790 CHAGRIN BLVD",
            "address_2": "SUITE # 250",
            "city": "WOODMERE",
            "state": "OH",
            "postal_code": "441224638",
            "telephone_number": "216-591-1916",
            "fax_number": "216-591-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOVAN",
        "first_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "18509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Alliance Healthcare of Ohio
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• Jovonn Nicole Gaskin
• Camryn Gomez
• Jenna Governor, RDN LD
• Tyana Grant
• Robert H. Harris, D.C.
• HS Medical Supply LLC

• All providers in Woodmere, OH
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.