Michael Garrett Goode, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9436 Issued in OR

Practice address

7417 Crater Lake Hwy
White City, OR 97503-1662

Phone

(541) 830-0043

NPI assigned

Jun 24, 2010

Sex

Male

Sole proprietor

Yes

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

Enrolled in OR

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

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.

• Goode Family Dental LLC

  • General Practice Dentistry
  • White City, OR
  • NPI 1154694776
  NPD (past) Authorized official

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

{
    "created_epoch": "1277337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310688000000",
    "number": "1124339122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7417 CRATER LAKE HWY",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975031662",
            "telephone_number": "541-830-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7417 CRATER LAKE HWY",
            "city": "WHITE CITY",
            "state": "OR",
            "postal_code": "975031662",
            "telephone_number": "541-830-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODE",
        "first_name": "MICHAEL",
        "middle_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-24",
        "last_updated": "2011-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francis Stanley Gilbert, PH.D.
• Simone Gillingham, RD, LD
• Ashley Taylor Glazener, PHARMD
• Jaimie Terra Good, RN
• Goode Family Dental LLC
• Victor Collins Gordon, RN
• Jennifer Anne Graham
• Jacob Graves, PA
• Michael E Greer II, LCSW
• Eric Gustafson, PHARM.D.

• General Practice Dentistry in White City, OR
• Providers in White City, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; 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.