Samuel Goodloe III, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

044038 Issued in NY

Practice address

1321 Millersport Hwy
Suite #201
Williamsville, NY 14221-2900

Phone

(716) 626-0001

Fax

(716) 626-0031

NPI assigned

May 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Samuel Goodloe III DDS MD PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Williamsville, NY
  • NPI 1518242320
  NPD (past)
• Suburban Oral & Maxillofacial Surgery Associates PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Williamsville, NY
  • NPI 1346433075
  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1144279191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 MILLERSPORT HWY",
            "address_2": "SUITE #201",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212900",
            "telephone_number": "716-626-0001",
            "fax_number": "716-626-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 MILLERSPORT HWY",
            "address_2": "SUITE #201",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212900",
            "telephone_number": "716-626-0001",
            "fax_number": "716-626-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODLOE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "044038",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "208101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crysti Golpl, LPN
• Good Neighbor Psychology PLLC
• Seth J Goodier, PT, DPT
• Jessica Goodison, RN
• Alexa Goodlander, LMT
• Caitlin Goodrich, LPN
• Stephanie D Goodwin, PNP
• Hari Gopal, M.D.
• Dellisa Gordon
• Sarah Goris, RPH

• Oral and Maxillofacial Surgery (Dentist) in Williamsville, NY
• Providers in Williamsville, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.