Nancy Lee Goodare-Rosenthal, DDS, MS

Primary specialty

DentistTaxonomy code 122300000X

License

019.030532 Issued in IL

Practice address

155 N Harbor Dr
Apt 2409
Chicago, IL 60601-5007

Phone

(312) 996-7546

Fax

(312) 355-4173

NPI assigned

Oct 13, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Nancy Lee Goodare Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Oral SurgeryAlso: Plastic and Reconstructive Surgery

Education

Marquette University School of Dentistry, 1987

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Valley-Wide Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
  • NPI 1205652047
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539907200000",
    "number": "1316935232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N HARBOR DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017364",
            "telephone_number": "719-588-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N HARBOR DR",
            "address_2": "APT 2409",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606015007",
            "telephone_number": "312-996-7546",
            "fax_number": "312-355-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODARE-ROSENTHAL",
        "first_name": "NANCY",
        "middle_name": "LEE",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2018-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.030532",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "8414",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60501332",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW MEXICO MEDICAID",
            "identifier": "94984018",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN HEALTH PLA",
            "identifier": "840706945137",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "GOODARE",
            "middle_name": "LEE",
            "credential": "DDS,MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Lynn Good, LCSW
• Nicole Marie Good, RN, HWNC-BC
• Hailee Goodale, RDN, LDN
• Wendy Carolyn Goodall McDonald, MD
• Perpetua Goodall
• Adam Jacob Goodcoff, DO
• Goode Incorporated
• Cressie A Goode, LPC
• Jeffrey Duane Goode, M.P.T.
• Lauren N Goode, LMT

• Dentist in Chicago, IL
• Providers in Chicago, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.