Jackson Pontz Goethe, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12014137A Issued in IN

Practice address

7373 E 21St St
Indianapolis, IN 46219-1753

Phone

(317) 357-7373

NPI assigned

Jun 27, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mark Kesler, D.D.S., P.C.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1144902693
  NPD
• Mark Kesler, D.D.S., P.C.

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1245860642
  NPD

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1184300766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 MAPLELEAF DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406715",
            "telephone_number": "989-859-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 E 21ST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462191753",
            "telephone_number": "317-357-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETHE",
        "first_name": "JACKSON",
        "middle_name": "PONTZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12014137A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ally Kathryn Goelz, DO
• James Goen, MD
• Joshua James Goergen, M.D.
• Lindsey Sarah Goergen, LMHC
• Grace Dury Goethe, PA-C
• Gail Lynne Goettler, MD
• Marissa Goetz
• Adam Goff, LMHC
• Trenton Duane Goffinet
• Alyssa Gogel

• Dentist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.