Active NPI
Jeff Goodman, D.D.S.
- Dentist
- Rolling Hills Estates, CA
National Provider Identifier
1134488778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36369
- Practice address
- 857 Silver Spur Rd
Rolling Hills Estates, CA 90274-3803 - Phone
- (310) 377-0966
- Fax
- (310) 377-5224
- NPI assigned
- May 15, 2012
- Last updated
- May 15, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 36369 | CA | Primary |
Addresses
Primary practice location
857 Silver Spur Rd
Rolling Hills Estates, CA 90274-3803
Mailing address
857 Silver Spur Rd
Rolling Hills Estates, CA 90274-3803
Phone (310) 377-0966
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 |
|---|---|---|---|
| 36369 | CA | MD | Licensed Psychiatric Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337040000000",
"number": "1134488778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "857 SILVER SPUR RD",
"city": "ROLLING HILLS ESTATES",
"state": "CA",
"postal_code": "902743803",
"telephone_number": "310-377-0966",
"fax_number": "310-377-5224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "857 SILVER SPUR RD",
"city": "ROLLING HILLS ESTATES",
"state": "CA",
"postal_code": "902743803",
"telephone_number": "310-377-0966",
"fax_number": "310-377-5224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "JEFF",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-15",
"last_updated": "2012-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "36369",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rolling Hills Estates, CA
- Fox Drug of Torrance, Inc. (DBA Skinners Pharmacy)
- Tamar Gamliel, D.C,
- Angela Garcia-Navarro, M.S., CCC-SLP
- Suzanne Gauthier-Pin, LMFT
- Get Psyched Clinical and Forensic Psychological Services LLC
- Graceful Nursing Hospice Care Inc
- Tania Grivas, M.D.
- Shawna Hagerty Regan, LAC
- Leah Ellenhorn Hahn
- Jennifer Helen Hall, BCBA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.