Individual provider Active NPI

Marc Goldenberg, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Boca Raton, FL
National Provider Identifier
1346622826
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DN21140 Issued in FL
Practice address
9250 Glades Rd Ste 208
Boca Raton, FL 33434-3958
Phone
(561) 756-9227
Fax
(561) 756-9215
NPI assigned
Jun 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN21140 FL Primary

Addresses

Primary practice location

9250 Glades Rd Ste 208
Boca Raton, FL 33434-3958

Mailing address

9250 Glades Rd Ste 208
Boca Raton, FL 33434-3958
Phone (561) 756-9227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20170501000451 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476830498

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN21140FLMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Goldenberg Orthodontics, P.a. Orthodontics and Dentofacial Orthopedics Current Accepting new patients

Locations

9250 Glades Rd
Ste 208
Boca Raton, FL 33434
Phone (561) 488-8898

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": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346622826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 GLADES RD STE 208",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343958",
            "telephone_number": "561-756-9227",
            "fax_number": "561-756-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 GLADES RD STE 208",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343958",
            "telephone_number": "561-756-9227",
            "fax_number": "561-756-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENBERG",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN21140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.