Individual provider Active NPI

Joseph H Goth III, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Moon Township, PA
National Provider Identifier
1194775809
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DS020845L Issued in 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
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 2

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph Goth LLC Oral and Maxillofacial Surgery CurrentSince Jan 11, 2008 Accepting new patients
Daniel W. Pituch, DMD, MD, PC Oral and Maxillofacial Surgery PastSince 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

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, 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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1194775809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BEAVER GRADE RD",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151082774",
            "telephone_number": "412-262-5091",
            "fax_number": "412-262-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 BEAVER GRADE RD",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151082774",
            "telephone_number": "412-262-5091",
            "fax_number": "412-262-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTH",
        "first_name": "JOSEPH",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS020845L",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "MD033127E",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moon Township, PA

Sources for this page

Verify at the official NPI Registry.