Amy Goodwin, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6021 Issued in NV

Practice address

6910 S Rainbow Blvd Ste 104
Las Vegas, NV 89118-3274

Phone

(702) 362-5437

Fax

(702) 631-5437

NPI assigned

Jun 27, 2008

Sex

Female

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

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Cavitybusters

  • Pediatric Dentistry
  • Las Vegas, NV
  • NPI 1538314372
  NPD (past)

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1063674356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9521 BOTTLE CREEK LN",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891170501",
            "telephone_number": "702-767-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 S RAINBOW BLVD STE 104",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891183274",
            "telephone_number": "702-362-5437",
            "fax_number": "702-631-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "AMY",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NV",
            "license": "6021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodwill Home Health LLC
• Goodwill Pharmacy Inc.
• Goodwill Ventures Inc
• Ellen Goodwill
• Alexis Marie Goodwin
• Antoinette Goodwin
• Deborah Vittum Goodwin, M.D.
• Demetria Goodwin
• Felecia Ann Goodwin
• Felicia Goodwin

• Pediatric Dentistry in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatric Dentistry in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.