Active NPI
Shelby L Goss
- Dental Hygienist
- Nanticoke, PA
National Provider Identifier
1124752605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH073600
- Practice address
- 124 S Hanover St Rear
Nanticoke, PA 18634-2219 - Phone
- (570) 592-3702
- NPI assigned
- Jul 12, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH073600 | PA | Primary |
Addresses
Primary practice location
124 S Hanover St Rear
Nanticoke, PA 18634-2219
Mailing address
124 S Hanover St Rear
Nanticoke, PA 18634-2219
Phone (570) 592-3702
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 |
|---|---|---|---|
| DH073600 | PA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1124752605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 S HANOVER ST REAR",
"city": "NANTICOKE",
"state": "PA",
"postal_code": "186342219",
"telephone_number": "570-592-3702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 S HANOVER ST REAR",
"city": "NANTICOKE",
"state": "PA",
"postal_code": "186342219",
"telephone_number": "570-592-3702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSS",
"first_name": "SHELBY",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "PA",
"license": "DH073600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nanticoke, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.