Joseph H Goth III, DMD, MD

Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Moon Township, PA

NPI 1194775809 · NPPES record last updated Feb 25, 2019

Key facts

NPI
1194775809
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
DS020845L (PA)
Practice address
980 Beaver Grade Rd
Moon Township, PA 15108-2774
Phone
(412) 262-5091
Fax
(412) 262-1090
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090608000146 PA Practitioner - Maxillofacial Surgery 2163572421 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD033127EPAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Goth LLC Oral and Maxillofacial Surgery Current
since Jan 11, 2008
Accepting new patients
Daniel W. Pituch, DMD, MD, PC Oral and Maxillofacial Surgery Past
since Jul 1, 2006
Accepting new patients
Dattilo and Hall LLC Oral and Maxillofacial Surgery Past Accepting new patients

Locations

980 Beaver Grade Rd
Moon Twp, PA 15108
Phone (412) 262-4911

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DS020845L PA Yes
Oral and Maxillofacial Surgery (Dentist) 1223S0112X MD033127E PA

Addresses

Primary practice location

980 Beaver Grade Rd
Moon Township, PA 15108-2774

Mailing address

980 Beaver Grade Rd
Moon Township, PA 15108-2774
Phone (412) 262-5091

Other providers in Moon Township, PA

All providers in Moon Township, PA · Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

Sources for this page

Verify at the official NPI Registry.