Individual provider Active NPI

Sheldon S Golomb, DDS

  • General Practice Dentistry
  • Colorado Springs, CO
National Provider Identifier
1194745109
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6201 Issued in CO
Practice address
5426 N Academy Blvd Ste 201
Colorado Springs, CO 80918-3687
Phone
(719) 528-6441
Fax
(719) 528-2488
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6201 CO Primary

Addresses

Primary practice location

5426 N Academy Blvd Ste 201
Colorado Springs, CO 80918-3687

Mailing address

1635 Fairoak Dr
Colorado Springs, CO 80918-3332
Phone (719) 531-5315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160322000506 CO Order and Referring Only - DentistPractitioner - Dentist 1153628920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Arts Center 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194745109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 FAIROAK DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183332",
            "telephone_number": "719-531-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5426 N ACADEMY BLVD STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809183687",
            "telephone_number": "719-528-6441",
            "fax_number": "719-528-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLOMB",
        "first_name": "SHELDON",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "6201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.