Cary N Goldberg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

19615 Governors Hwy
Flossmoor, IL 60422-2037

Phone

(708) 647-6453

NPI assigned

Dec 13, 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 5, 2016 through Jan 5, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Center for Dental Excellence, LLC

  • Dentist
  • Flossmoor, IL
  • NPI 1639325293
  NPD (past)

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215098074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19615 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222037",
            "telephone_number": "708-647-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19615 GOVERNORS HWY",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222037",
            "telephone_number": "708-647-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "CARY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Gervasi, APN
• Nuha Ghosein
• Brittany Gibbs, PT
• Joshua Gibson, PARAMEDIC
• Go T.a. LLC
• Arlana L Goodall
• Marcita Gooley, MA, LCPC
• Tina Goolsby
• Gracious Services LLC
• Grand Prairie Services

• General Practice Dentistry in Flossmoor, IL
• Providers in Flossmoor, IL by specialty
• General Practice Dentistry in Illinois

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.