Dr. Myron B. Goldberg, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS020079-L Issued in PA

Legal business name

DR. MYRON B. GOLDBERG, D.D.S.

Practice address

1528 Walnut St
Suite 1725
Philadelphia, PA 19102-3604

Phone

(215) 732-0505

Fax

(215) 732-8744

NPI assigned

Jul 21, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Myron B Goldberg, D.D.S.NPI 1710026554

Title

Dentist

Phone

(215) 732-0505

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Myron B Goldberg, D.D.S.

  • Dentist
  • Philadelphia, PA
  • NPI 1710026554
  NPD (past) Authorized official

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

{
    "created_epoch": "1279670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426809600000",
    "number": "1134432909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST",
            "address_2": "SUITE 1725",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023604",
            "telephone_number": "215-732-0505",
            "fax_number": "215-732-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST",
            "address_2": "SUITE 1725",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023604",
            "telephone_number": "215-732-0505",
            "fax_number": "215-732-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MYRON B. GOLDBERG, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-21",
        "last_updated": "2015-03-20",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "MYRON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "215-732-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS020079-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.