Individual provider Active NPI

Pamala Lyn Good, D.M.D.

  • General Practice Dentistry
  • Tallahassee, FL
National Provider Identifier
1306113444
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 19586 Issued in FL
Practice address
2808 Remington Green Cir Ste 100
Tallahassee, FL 32308-3724
Phone
(850) 383-1052
NPI assigned
Nov 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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 DN 19586 FL Primary

Addresses

Primary practice location

2808 Remington Green Cir Ste 100
Tallahassee, FL 32308-3724

Mailing address

3640 Mossy Creek LN
Tallahassee, FL 32311-3638
Phone (850) 228-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20151104001624 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214247170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN 19586FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
JNR Dental General Practice Past Accepting new patients
NBW, D.D.S., Inc. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1306113444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 MOSSY CREEK LN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323113638",
            "telephone_number": "850-228-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 REMINGTON GREEN CIR STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323083724",
            "telephone_number": "850-383-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOD",
        "first_name": "PAMALA",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 19586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.