Lawrence I Goldblatt, DDS MSD

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

12007207 Issued in IN

Practice address

1121 W Michigan St
Room 285
Indianapolis, IN 46202-5211

Phone

(317) 274-7668

Fax

(317) 274-3346

NPI assigned

Mar 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Indiana University

  dba Indiana University School of Dentistry

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552
  Medicare reassignment
• University Dental Service Plan Inc

  dba Dental Faculty Private Practice

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1407996291

  Oral and Maxillofacial Pathology

  NPD

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255308011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "address_2": "ROOM 285",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-7668",
            "fax_number": "317-274-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "address_2": "ROOM 285",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-7668",
            "fax_number": "317-274-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "LAWRENCE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "DDS MSD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "IN",
            "license": "12007207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000211690",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Lynn Gold, FNP
• Aaron Joseph Goldberg, M.D.
• Mark J. Goldberg, M.D.
• Michael Anatolevich Goldberg
• Pinkus Goldberg, M.D.
• Golden Age Companions Home Care LLC
• Golden Care Home Health Services LLC (Golden Care Home Health Services)
• Golden Compassion Home Care LLC
• Golden Compassion Home Health Solutions LLC
• Golden Gardens. LLC

• Oral and Maxillofacial Pathology Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Oral and Maxillofacial Pathology Dentistry in Indiana

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

Verify at the official NPI Registry.