Individual provider Active NPI

Sammy Goldstein, DDS

  • General Practice Dentistry
  • Union City, NJ
National Provider Identifier
1316002645
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14852 Issued in NJ
Practice address
707 Summit Ave Ste 2
Union City, NJ 07087-3463
Phone
(201) 863-0816
Fax
(201) 866-3448
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 14852 NJ Primary

Addresses

Primary practice location

707 Summit Ave Ste 2
Union City, NJ 07087-3463

Mailing address

56 Woodglen Dr
New City, NY 10956-4227
Phone (845) 634-7231

Other identifiers 1

IdentifierTypeStateIssuer
3628906MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150721002521 NJ Order and Referring Only - DentistPractitioner - Dentist 9032422928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14852NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob S Cohen & Sammy Goldstein DDS PC General Practice Past 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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1316002645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WOODGLEN DR",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564227",
            "telephone_number": "845-634-7231",
            "fax_number": "201-866-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SUMMIT AVE STE 2",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070873463",
            "telephone_number": "201-863-0816",
            "fax_number": "201-866-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "SAMMY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "14852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3628906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

Verify at the official NPI Registry.