Active NPI
Thomas Matthew Goebel, DMD
- Endodontics
- Groton, CT
National Provider Identifier
1093894578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 8904
- Practice address
- 491 Gold Star Hwy Ste 200
Groton, CT 06340-6226 - Phone
- (860) 446-2357
- Fax
- (860) 446-2359
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 8904 | CT | Primary |
Addresses
Primary practice location
491 Gold Star Hwy Ste 200
Groton, CT 06340-6226
Mailing address
110 Rowley Dr
Stonington, CT 06378-2022
Phone (860) 912-9323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8904 | CT | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624492800000",
"number": "1093894578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ROWLEY DR",
"city": "STONINGTON",
"state": "CT",
"postal_code": "063782022",
"telephone_number": "860-912-9323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "491 GOLD STAR HWY STE 200",
"city": "GROTON",
"state": "CT",
"postal_code": "063406226",
"telephone_number": "860-446-2357",
"fax_number": "860-446-2359"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOEBEL",
"first_name": "THOMAS",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-03",
"last_updated": "2021-06-24",
"certification_date": "2021-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CT",
"license": "8904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groton, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.