Daniel T Goodman DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2005015020 Issued in MO

Legal business name

DANIEL T GOODMAN DDS LLC

Practice address

315 E Broadway St
Bolivar, MO 65613

Phone

(417) 326-4113

Fax

(417) 326-4115

NPI assigned

Aug 4, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Daniel T Goodman, DDSNPI 1699835603

Title

Doctor Owner

Phone

(417) 326-4113

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Tim Goodman Jr., D.D.S

  • General Practice Dentistry
  • Bolivar, MO
  • NPI 1699835603
  NPD (past) Authorized official
• Thomas Eugene Heinrichs, D.D.S.

  • Dentist
  • Bolivar, MO
  • NPI 1982793816

  General Practice

  NPD (past)

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1124284658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E BROADWAY ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "65613",
            "telephone_number": "417-326-4113",
            "fax_number": "417-326-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 E BROADWAY ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "65613",
            "telephone_number": "417-326-4113",
            "fax_number": "417-326-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL T GOODMAN DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-04",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DOCTOR OWNER",
        "authorized_official_telephone_number": "417-326-4113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2005015020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Jenae Cumley, FNP
• Carol D Curless, FNP
• Mandy R D'Agostino, FNP-C
• Dan McHan Store in
• Dan McHans Store Inc
• Kristi Darnell, MS
• Kristen Davern, ATC, LAT
• Makaela Dawn David
• Inta Davidyuk, FNP
• Melissa Davis, LCSW

• General Practice Dentistry in Bolivar, MO
• Providers in Bolivar, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.