Active NPI
Justin Goff, DDS
- General Practice Dentistry
- Montgomery, TX
National Provider Identifier
1205453370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 36252
- Practice address
- 20042 Eva St Ste 100
Montgomery, TX 77356-2042 - Phone
- (936) 206-7069
- NPI assigned
- Jul 6, 2020
- Last updated
- Jul 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 36252 | TX | Primary |
Addresses
Primary practice location
20042 Eva St Ste 100
Montgomery, TX 77356-2042
Mailing address
20042 Eva St Ste 100
Montgomery, TX 77356-2042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36252 | TX | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dentists of Montgomery, PC | 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, 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": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593993600000",
"number": "1205453370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20042 EVA ST STE 100",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773562042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20042 EVA ST STE 100",
"city": "MONTGOMERY",
"state": "TX",
"postal_code": "773562042",
"telephone_number": "936-206-7069"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOFF",
"first_name": "JUSTIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-07-06",
"last_updated": "2020-07-06",
"certification_date": "2020-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "36252",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montgomery, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.