A Gary Goodman, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5906 Issued in MD

Practice address

1419 Forest Dr
Suite 207
Annapolis, MD 21403

Phone

(410) 263-1919

Fax

(410) 267-9163

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194832436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 FOREST DR",
            "address_2": "SUITE 207",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21403",
            "telephone_number": "410-263-1919",
            "fax_number": "410-267-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 FOREST DR",
            "address_2": "SUITE 207",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "21403",
            "telephone_number": "410-263-1919",
            "fax_number": "410-267-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "A",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "5906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Yosefind Gonzalez
• Katherine Good, M.S., CCC-SLP
• Mark Cameron Good, LCSW-C, BCD, PH.D.
• Marvin D Goodley
• Goodman Dental Care LLC
• Jeremy Haskell Goodman, DDS
• Lee A. Goodman, MD
• Marie Darcy Goodman, PA-C
• Frederick K Goodwin, M.D.
• Sheila Kay Goodwin, RN

• Dentist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Dentist in Maryland

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.