Michael S. Goodman, D. D. S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

003955 Issued in CT

Practice address

1315 Main St
Willimantic, CT 06226-1948

Phone

(860) 450-7471

Fax

(860) 423-4629

NPI assigned

Apr 18, 2006

Last updated

Jul 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kidz R Kool

  • Pediatric Dentistry
  • Peoria, AZ
  • NPI 1336535152
  NPD (past)
• Morghan E. Teeters DMD, PLLC

  • Pediatric Dentistry
  • Peoria, AZ
  • NPI 1629616826
  NPD (past)

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1043275548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W GRAYLING LN",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060781960",
            "telephone_number": "860-668-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261948",
            "telephone_number": "860-450-7471",
            "fax_number": "860-423-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MICHAEL",
        "middle_name": "S.",
        "credential": "D. D. S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "003955",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CT",
            "license": "003955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Giordano
• Jessica L. Giordano, M.S, LMFT
• Rose K Godfrey
• Max Austin Goldstein, M.D.
• Rosana Gonzalez
• Sydney M Goodwin
• John Phillip Gorman III
• Carly Gottehrer, LPC
• Aleksandr Y Gozun
• John N Graham, M.D.

• Pediatric Dentistry in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.