Active NPI
Courtney Marie Goler
- Pediatric Dentistry
- Prescott, AZ
National Provider Identifier
1225565724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 01530
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 01530 | AZ | MD | Pediatric 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.