Tracy G Golden, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

33208 Issued in CA

Practice address

10921 Wilshire Blvd
1009
Los Angeles, CA 90024-3906

Phone

(310) 209-7572

Fax

(310) 209-7574

NPI assigned

Jun 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

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

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093741183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD",
            "address_2": "1009",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243906",
            "telephone_number": "310-209-7572",
            "fax_number": "310-209-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 WILSHIRE BLVD",
            "address_2": "1009",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900243906",
            "telephone_number": "310-209-7572",
            "fax_number": "310-209-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "TRACY",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "33208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "33208",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles V Golden, DO
• Jaynee Golden, LCSW
• Kraig L Golden, M.D.
• Stacey Golden
• Stanley Golden, MD
• Emily Goldenberg, M.D.
• Irene Toby Goldenberg
• Mark David Goldenberg
• Mitchell Geoffrey Goldenberg, MBBS, PHD
• Stanley William Goldenberg, RPH

• Periodontics in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.