Eric Paul Gothelf, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

040189 Issued in NY

Practice address

6121 Roosevelt Ave
Woodside, NY 11377-3569

Phone

(718) 458-0940

Fax

(718) 458-1319

NPI assigned

Nov 11, 2005

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 NY

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

State licenses

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255312641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6121 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773569",
            "telephone_number": "718-458-0940",
            "fax_number": "718-458-1319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 ROOSEVELT AVE",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113773569",
            "telephone_number": "718-458-0940",
            "fax_number": "718-458-1319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTHELF",
        "first_name": "ERIC",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "040189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00983537",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janinne Gonzalez
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• Sharon Casandra Gonzalez, LMSW
• Cassandra Goojha
• Clyde Lace De Guzman Gorobat
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• Angela Gralian
• Gramercy Medical PC
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• Dentist in Woodside, NY
• Providers in Woodside, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.