NPIMap

Organization Active NPI

Brett S. Goymerac DDS PC

  • General Practice Dentistry
  • Marquette, MI
National Provider Identifier
1174602262
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BRETT S. GOYMERAC DDS PC
Practice address
760 W Washington St
Marquette, MI 49855-4138
Phone
(906) 228-4646
Fax
(906) 228-4166
NPI assigned
Nov 2, 2006
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Dr. Brett S. Goymerac, DDSNPI 1356304422
Title
Owner/DDS
Phone
(906) 228-4646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X MI Primary

Addresses

Primary practice location

760 W Washington St
Marquette, MI 49855-4138

Mailing address

760 W Washington St
Marquette, MI 49855-4138
Phone (906) 228-4646

Other identifiers 1

IdentifierTypeStateIssuer
D801178OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

760 W Washington St
Marquette, MI 49855
Phone (906) 228-4646

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1174602262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 W WASHINGTON ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554138",
            "telephone_number": "906-228-4646",
            "fax_number": "906-228-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 W WASHINGTON ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554138",
            "telephone_number": "906-228-4646",
            "fax_number": "906-228-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRETT S. GOYMERAC DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "GOYMERAC",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "906-228-4646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "D801178",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.