Active NPI
Gregory Golder, DDS
- Dentist
- Brooklyn, NY
National Provider Identifier
1255446365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 048890
- Practice address
- 7101 Bay Parkway
Ste 1 5
Brooklyn, NY 11204 - Phone
- (718) 232-8922
- Fax
- (718) 232-5512
- NPI assigned
- Aug 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 048890 | NY | Primary |
Addresses
Primary practice location
7101 Bay Parkway
Ste 1 5
Brooklyn, NY 11204
Mailing address
7101 Bay Parkway
Ste 1 5
Brooklyn, NY 11204
Phone (718) 232-8922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02129019 | Medicaid | NY |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160419001028 | NY | Order and Referring Only - Dentist | 7911205307 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048890 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1255446365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7101 BAY PARKWAY",
"address_2": "STE 1 5",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11204",
"telephone_number": "718-232-8922",
"fax_number": "718-232-5512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7101 BAY PARKWAY",
"address_2": "STE 1 5",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11204",
"telephone_number": "718-232-8922",
"fax_number": "718-232-5512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDER",
"first_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "048890",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02129019",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- 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.