Mark Golub, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

401005546 Issued in VA

Practice address

1451 Belle Haven Rd
Suite 340
Alexandria, VA 22307-1201

Phone

(703) 765-3366

NPI assigned

Jun 14, 2015

Sex

Male

Sole proprietor

No

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

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.

Opted out of Medicare

Yes, effective Jul 11, 2015 through Jul 11, 2027

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.

• Mark E Golub DDS PLC

  • General Practice Dentistry
  • Alexandria, VA
  • NPI 1114930310
  NPD (past) Authorized official

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

{
    "created_epoch": "1434240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434240000000",
    "number": "1093196263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 BELLE HAVEN RD",
            "address_2": "SUITE 340",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223071201",
            "telephone_number": "703-765-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 BELLE HAVEN RD",
            "address_2": "SUITE 340",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223071201",
            "telephone_number": "703-765-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUB",
        "first_name": "MARK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-14",
        "last_updated": "2015-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "401005546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Goldberg, DO
• Melissa Faye Goldblatt, C.P.N.P.
• Goldhealthpro LLC
• Wanda M Goldhush, D.D.S.
• Joel Gregory Goldman, M.D.
• Shirley Golub, LPC
• Karynn Suzette Gomes, NP-C
• Rosa M Gomes
• Danielle Gomez
• Elaine Gomez

• Dentist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.