Individual provider Active NPI

Kristin Heller Goodell, DDS

  • General Practice Dentistry
  • Augusta, GA
National Provider Identifier
1194125708
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN122600 Issued in GA
Practice address
1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001
Phone
(706) 721-2371
Fax
(706) 721-6778
NPI assigned
Sep 2, 2014
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30410 TX
General Practice Dentistry 1223G0001X 9968 NC
General Practice Dentistry 1223G0001X DN122600 GA Primary

Addresses

Primary practice location

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001

Mailing address

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001
Phone (706) 721-2371

Other names 1

  • Kristin Dee Heller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160602002491 NC Order and Referring Only - DentistPractitioner - Dentist 9638469612
I20231011001001 GA Order and Referring Only - DentistPractitioner - Dentist 9638469612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN122600GAMDGeneral Practice Dentistry
30410TXMDGeneral Practice Dentistry
9968NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Adamson & Assoc., Fayetteville, P.a. General Practice Past Accepting new patients
DRS. Cameron & Roman I, PA General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1194125708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-2371",
            "fax_number": "706-721-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-2371",
            "fax_number": "706-721-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODELL",
        "first_name": "KRISTIN",
        "middle_name": "HELLER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30410",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9968",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN122600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "HELLER",
            "middle_name": "DEE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.