Mark Goldstein, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS18048L Issued in PA

Practice address

6404 Roosevelt Blvd
Philadelphia, PA 19149-2943

Phone

(215) 743-3700

Fax

(215) 743-3706

NPI assigned

Aug 31, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Infant Laser Dentistry PC

  • Pediatric Dentistry
  • Philadelphia, PA
  • NPI 1992154421
  Authorized official Same address or phone

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144214511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492943",
            "telephone_number": "215-743-3700",
            "fax_number": "215-743-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6404 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492943",
            "telephone_number": "215-743-3700",
            "fax_number": "215-743-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MARK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS18048L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00529928",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lilach Goldstein, MD
• Lori Ann Goldstein, MD
• Lori J Goldstein, M.D.
• Marc F Goldstein, M.D.
• Marjorie Goldstein, CRNA
• Melissa Goldstein
• Michele Glazer Goldstein, M.S.
• Mitchell Goldstein, MD
• Reed David Goldstein, PH.D.
• Richard Lee Goldstein, MD

• Pediatric Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.