Individual provider Active NPI

Courtney Marie Goler

  • Pediatric Dentistry
  • Prescott, AZ
National Provider Identifier
1225565724
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
01530 Issued in AZ
Practice address
3626 Crossings Dr
Prescott, AZ 86305-7137
Phone
(928) 445-5959
NPI assigned
May 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 01530 AZ Primary

Addresses

Primary practice location

3626 Crossings Dr
Prescott, AZ 86305-7137

Mailing address

5375 Rainbow Cliff PL
Prescott, AZ 86301-5547
Phone (928) 308-3237

Other practice location 1

100 Az-89
Chino Valley, AZ 86323
Phone (928) 445-5959

Other practice location 2

7763 E Florentine Rd
Prescott Valley, AZ 86314-2289
Phone (928) 445-5959

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
01530AZMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1225565724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5375 RAINBOW CLIFF PL",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015547",
            "telephone_number": "928-308-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 CROSSINGS DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863057137",
            "telephone_number": "928-445-5959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 AZ-89",
            "address_purpose": "LOCATION",
            "city": "Chino Valley",
            "state": "AZ",
            "postal_code": "86323",
            "country_code": "US",
            "telephone_number": "928-445-5959",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7763 E Florentine Rd",
            "address_purpose": "LOCATION",
            "city": "Prescott Valley",
            "state": "AZ",
            "postal_code": "863142289",
            "country_code": "US",
            "telephone_number": "928-445-5959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLER",
        "first_name": "COURTNEY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "01530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.