Active NPI
Zachary M Goodman, DDS
- General Practice Dentistry
- Minden, LA
National Provider Identifier
1184764540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5767
- Practice address
- 909 Elm St
Minden, LA 71055-2747 - Phone
- (318) 377-9411
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5767 | LA | Primary |
Addresses
Primary practice location
909 Elm St
Minden, LA 71055-2747
Mailing address
709 Nella St
Minden, LA 71055-3040
Phone (318) 382-1845
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5767 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elm Street Dental Center, LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Minden, LA
- NPI 1972648186
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184764540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 NELLA ST",
"city": "MINDEN",
"state": "LA",
"postal_code": "710553040",
"telephone_number": "318-382-1845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 ELM ST",
"city": "MINDEN",
"state": "LA",
"postal_code": "710552747",
"telephone_number": "318-377-9411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "ZACHARY",
"middle_name": "M",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "5767",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minden, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.