Brooke D Goodwin, DDS
Individual provider Active NPI General Practice Dentistry · Dayton, VA
NPI 1124307202 · NPPES record last updated Mar 5, 2015
Key facts
- NPI
- 1124307202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401414699 (VA)
- Practice address
- 101 Heartland CT
Dayton, VA 22821-9000 - Phone
- (540) 879-9211
- Fax
- (540) 879-9007
- NPI assigned
- Aug 8, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401414699 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartland Health Clinic | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401414699 | VA | Yes |
Addresses
Primary practice location
101 Heartland CT
Dayton, VA 22821-9000
Mailing address
101 Heartland CT
Dayton, VA 22821-9000
Phone (540) 879-9211
Other providers in Dayton, VA
- James R Brodersen
- Peggy J Byler
- Melissa Deaton Cook
- Erica Espy
- Daniel Austin Floyd
- Kelli F Hanon
- Heartland Health Clinic
- Heartland Home LLC
- Bethany Lynnell Landes
- Michael Marsh
All providers in Dayton, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.