Individual provider Active NPI

David Goldberg, D.D.S.

  • General Practice Dentistry
  • Royal Palm Beach, FL
National Provider Identifier
1326196791
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN10503 Issued in FL
Practice address
11358 Okeechobee Blvd
Suite 1
Royal Palm Beach, FL 33411-8723
Phone
(561) 790-0177
Fax
(561) 790-5291
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 DN10503 FL Primary

Addresses

Primary practice location

11358 Okeechobee Blvd
Suite 1
Royal Palm Beach, FL 33411-8723

Mailing address

11358 Okeechobee Blvd
Suite 1
Royal Palm Beach, FL 33411-8723
Phone (561) 790-0177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150623001786 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103137757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN10503FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Palm Dental Associates, P.a. 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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326196791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11358 OKEECHOBEE BLVD",
            "address_2": "SUITE 1",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118723",
            "telephone_number": "561-790-0177",
            "fax_number": "561-790-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11358 OKEECHOBEE BLVD",
            "address_2": "SUITE 1",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118723",
            "telephone_number": "561-790-0177",
            "fax_number": "561-790-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN10503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.