Individual provider Active NPI

Vance Goldstein, DDS

  • Dentist
  • Brooklyn, NY
National Provider Identifier
1326144247
Registry record updated Jan 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
042504 Issued in NY
Practice address
206 Livingston St Ste 2
Brooklyn, NY 11201-7266
Phone
(718) 638-3900
Fax
(347) 335-0382
NPI assigned
Sep 16, 2006
Last updated
Jan 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042504 NY Primary

Addresses

Primary practice location

206 Livingston St Ste 2
Brooklyn, NY 11201-7266

Mailing address

206 Livingston St Ste 2
Brooklyn, NY 11201-7266
Phone (718) 638-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151230002098 NY Order and Referring Only - DentistPractitioner - Dentist 4981906450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
042504NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547251200000",
    "number": "1326144247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 LIVINGSTON ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112017266",
            "telephone_number": "718-638-3900",
            "fax_number": "347-335-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 LIVINGSTON ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112017266",
            "telephone_number": "718-638-3900",
            "fax_number": "347-335-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "VANCE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2019-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.