Individual provider Active NPI

Harry J Goldschein, DDS

  • Dentist
  • Daytona Beach, FL
National Provider Identifier
1306188040
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN8342 Issued in FL
Practice address
1500 Beville Rd Ste 403
Daytona Beach, FL 32114
Phone
(386) 253-6634
Fax
(386) 258-8775
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN8342 FL Primary

Addresses

Primary practice location

1500 Beville Rd Ste 403
Daytona Beach, FL 32114

Mailing address

1120 State Road 436
Suite 1800
Casselberry, FL 32707
Phone (407) 977-7079

Other identifiers 1

IdentifierTypeStateIssuer
1811085509OtherFLNPI

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
I20170123000422 FL Order and Referring Only - DentistPractitioner - Other (Physician)Practitioner - Dentist 7719269026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coast Florida P.a. Dentist Past Accepting new patients
Coast Florida P.a. Dentist PastSince Jun 22, 2021 Accepting new patients

Networks

  • Freedom Health HMO Network

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1306188040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 STATE ROAD 436",
            "address_2": "SUITE 1800",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "32707",
            "telephone_number": "407-977-7079",
            "fax_number": "407-677-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 BEVILLE RD STE 403",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-253-6634",
            "fax_number": "386-258-8775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSCHEIN",
        "first_name": "HARRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN8342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811085509",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.