Active NPI
Jeremy Goldenberg
- Dentist
- Scarsdale, NY
National Provider Identifier
1295140580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 058221
- Practice address
- 842 White Plains Rd
Scarsdale, NY 10583-5507 - Phone
- (914) 725-0707
- NPI assigned
- Jun 25, 2014
- 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 | 058221 | NY | Primary |
Addresses
Primary practice location
842 White Plains Rd
Scarsdale, NY 10583-5507
Mailing address
842 White Plains Rd
Scarsdale, NY 10583-5507
Phone (914) 725-0707
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
| License | State | Type | Specialty |
|---|---|---|---|
| 058221 | NY | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727136000000",
"number": "1295140580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "842 WHITE PLAINS RD",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "105835507",
"telephone_number": "914-725-0707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "842 WHITE PLAINS RD",
"city": "SCARSDALE",
"state": "NY",
"postal_code": "105835507",
"telephone_number": "914-725-0707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDENBERG",
"first_name": "JEREMY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-25",
"last_updated": "2024-09-24",
"certification_date": "2024-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "058221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scarsdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.