Laura Elizabeth Goodell, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

1001695 Issued in WI

Practice address

2100 Miller Park Way
West Milwaukee, WI 53219-1641

Phone

(262) 436-3363

NPI assigned

Jun 10, 2011

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Laura Elizabeth Battaglia Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bright Side Pediatric Dentistry LLC

  • Pediatric Dentistry
  • West Bend, WI
  • NPI 1215889936
  NPD Authorized official
• Dental Associates LTD of Wisconsin

  • Endodontics
  • Wauwatosa, WI
  • NPI 1518266998

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1346535002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N97W14947 BURNING BUSH CT",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226628",
            "telephone_number": "608-712-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MILLER PARK WAY",
            "city": "WEST MILWAUKEE",
            "state": "WI",
            "postal_code": "532191641",
            "telephone_number": "262-436-3363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 Dolphin Ct",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531861488",
            "country_code": "US",
            "telephone_number": "262-436-3363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODELL",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30-023846",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WI",
            "license": "1001695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BATTAGLIA",
            "middle_name": "ELIZABETH",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fresh Coast Dental I LLC (Fresh Coast Dental)
• Lynn A Garnaas, PHARM.D., RPH
• Pamela Ann Gentile, DDS
• Aleksandr Gershteyn, PHARM.D.
• Epiphany A Gold, LPN
• Great Lakes Orthotics & Medical Supply, Inc.
• Michael Gremban
• Trista M Grudzinski, LPN
• Audra L Hale, APNP
• Kourtney K Haller, RN

• Pediatric Dentistry in West Milwaukee, WI
• Providers in West Milwaukee, WI by specialty
• Pediatric Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.