NPIMap

Individual provider Active NPI

Mark J Goch, D.D.S.

  • Dentist
  • Canton, GA
National Provider Identifier
1225289374
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN012338 Issued in GA
Practice address
230 Riverstone Pkwy Ste a
Canton, GA 30114-6414
Phone
(770) 479-5425
NPI assigned
Oct 7, 2008
Last updated
Oct 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN012338 GA Primary

Addresses

Primary practice location

230 Riverstone Pkwy Ste a
Canton, GA 30114-6414

Mailing address

230 Riverstone Pkwy Ste a
Canton, GA 30114-6414
Phone (770) 479-5425

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

LicenseStateTypeSpecialty
DN012338GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark J Goch DDS PC Past Accepting new patients
Canton Dental, LLC Past Accepting new patients

Organizations & group practices 2

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": "1223337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1225289374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 RIVERSTONE PKWY STE A",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301146414",
            "telephone_number": "770-479-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 RIVERSTONE PKWY STE A",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301146414",
            "telephone_number": "770-479-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOCH",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.