Richard Bruce Goldman, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

036172 Issued in NY

Practice address

18 Thatch Pond Rd
Smithtown, NY 11787-1828

Phone

(917) 747-8552

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1265460950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 THATCH POND RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871828",
            "telephone_number": "917-747-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 THATCH POND RD",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117871828",
            "telephone_number": "917-747-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDMAN",
        "first_name": "RICHARD",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "036172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Bongiorno Goitia, RN
• Gold Coast Physical Therapists & Therapy Assistants
• Gold Coast Podiatry, PC
• Avram Gold, M.D.
• Richard Samuel Gold, MD
• Thomas Michael Goldrick, RPA
• Jenna Nicole Goldstein, PA-C
• Richard Scott Goldstein, MD
• Tracy-Lynn Patricia Goldstein, LMSW, LCSW
• Vanessa Fonseca Gomes, PHD

• General Practice Dentistry in Smithtown, NY
• Providers in Smithtown, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.