Active NPI
Marshall Goldberg, D.D.S., M.S.D.
- Dentist
- Coos Bay, OR
National Provider Identifier
1174557938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 18699
- Practice address
- 837 Zanna PL
Coos Bay, OR 97420-2899 - Phone
- (949) 610-5513
- Fax
- (541) 808-2768
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 18699 | CA | |
| Dentist | 122300000X | 18699 | CA | Primary |
Addresses
Primary practice location
837 Zanna PL
Coos Bay, OR 97420-2899
Mailing address
PO Box 1435
Coos Bay, OR 97420-0349
Phone (949) 610-5513
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
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18699 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corona Dermatology Center Inc. | Past | Accepting new patients | |
| Upland Dermatology Center | Past | Accepting new patients | |
| California Dermatology Center | Past | Accepting new patients | |
| Seton Emergency Physicians | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Procedural Dermatology Physician
- Diamond Bar, CA
- NPI 1407883770
-
- Dermatology Physician
- Corona, CA
- NPI 1790890085
-
- Emergency Medicine Physician
- Jeannette, PA
- NPI 1386693943
-
- Specialist
- Upland, CA
- NPI 1629002167
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398902400000",
"number": "1174557938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1435",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974200349",
"telephone_number": "949-610-5513",
"fax_number": "541-808-2768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "837 ZANNA PL",
"city": "COOS BAY",
"state": "OR",
"postal_code": "974202899",
"telephone_number": "949-610-5513",
"fax_number": "541-808-2768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "MARSHALL",
"credential": "D.D.S., M.S.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2014-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "18699",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "18699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coos Bay, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.