Organization Active NPI

Jeffrey a & Mark Goldstein DDS PLLC

  • Dentist
  • So Ozone Park, NY
National Provider Identifier
1053386110
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
028052 Issued in NY
Legal business name
JEFFREY A & MARK GOLDSTEIN DDS PLLC
Practice address
131-11 Rockaway Blvd
So Ozone Park, NY 11420
Phone
(718) 322-9607
Fax
(718) 322-9614
NPI assigned
Feb 22, 2006
Last updated
Nov 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Dr. Mark Neil Goldstein, DDS
Title
Partner
Phone
(718) 322-9607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 028052 NY Primary

Addresses

Primary practice location

131-11 Rockaway Blvd
So Ozone Park, NY 11420

Mailing address

131-11 Rockaway Blvd
So Ozone Park, NY 11420
Phone (718) 322-9607

Other identifiers 1

IdentifierTypeStateIssuer
00287967MedicaidNY

National Provider Directory

National Provider Directory

Locations

13111 Rockaway Blvd
South Ozone Park, NY 11420
Phone (718) 322-9607

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1053386110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131-11 ROCKAWAY BLVD",
            "city": "SO OZONE PARK",
            "state": "NY",
            "postal_code": "11420",
            "telephone_number": "718-322-9607",
            "fax_number": "718-322-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131-11 ROCKAWAY BLVD",
            "city": "SO OZONE PARK",
            "state": "NY",
            "postal_code": "11420",
            "telephone_number": "718-322-9607",
            "fax_number": "718-322-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY A & MARK GOLDSTEIN DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "NEIL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "718-322-9607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "028052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00287967",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in So Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.