Active NPI
Rebecca Haley Goldberg, DDS
- Pediatric Dentistry
- Highlands Ranch, CO
National Provider Identifier
1063723252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 10722
- Practice address
- 1165 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2246 - Phone
- (303) 470-5543
- NPI assigned
- Jun 23, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 10722 | CO | Primary |
Addresses
Primary practice location
1165 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2246
Mailing address
1165 SGT Jon Stiles Dr
Highlands Ranch, CO 80129-2246
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170111002020 | CO | Order and Referring Only - Other (Physician) | 8820379563 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10722 | CO | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344816000000",
"number": "1063723252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1165 SGT JON STILES DR",
"city": "HIGHLANDS RANCH",
"state": "CO",
"postal_code": "801292246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1165 SGT JON STILES DR",
"city": "HIGHLANDS RANCH",
"state": "CO",
"postal_code": "801292246",
"telephone_number": "303-470-5543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "REBECCA",
"middle_name": "HALEY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2012-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "10722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highlands Ranch, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2012; 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.