Individual provider Active NPI

Joseph Francis Goodreau, D.D.S.

  • General Practice Dentistry
  • Deland, FL
National Provider Identifier
1285809285
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0008174 Issued in FL
Practice address
111 S Dexter Ave
Deland, FL 32720-5111
Phone
(386) 734-0482
NPI assigned
Apr 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN0008174 FL Primary

Addresses

Primary practice location

111 S Dexter Ave
Deland, FL 32720-5111

Mailing address

111 S Dexter Ave
Deland, FL 32720-5111
Phone (386) 734-0482

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

LicenseStateTypeSpecialty
DN0008174FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Deep Sleep Dental Solutions, LLC General Practice PastSince May 17, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1285809285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S DEXTER AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327205111",
            "telephone_number": "386-734-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S DEXTER AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327205111",
            "telephone_number": "386-734-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODREAU",
        "first_name": "JOSEPH",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0008174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.