Jason Marc Golnick, DDS, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2901016484 Issued in MI

Practice address

21213 Ecorse Rd
Taylor, MI 48180-1834

Phone

(313) 292-7777

Fax

(313) 292-7515

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Golnick Pediatric Dental Associates

  • Dental Clinic/Center
  • Taylor, MI
  • NPI 1548444102
  NPD (past) Authorized official

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316915044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21213 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801834",
            "telephone_number": "313-292-7777",
            "fax_number": "313-292-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21213 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801834",
            "telephone_number": "313-292-7777",
            "fax_number": "313-292-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLNICK",
        "first_name": "JASON",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901016484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lanetria A Gibson
• Jeanette Gill
• God'S Precious Treasures II
• Krishna Gollamudi, MD
• Golnick Pediatric Dental Associates
• Hannah Gomez
• Melissa Rose Gonzales, LMSW
• Good Heart Homecare Services
• Good Step LLC
• Pamela Goodloe

• Pediatric Dentistry in Taylor, MI
• Providers in Taylor, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.