Robert John Goeckermann, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5910-015 Issued in WI

Practice address

6800 W Layton Avenue
Greenfield, WI 53220-4364

Phone

(414) 281-3344

Fax

(414) 281-1080

NPI assigned

Jul 2, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 10, 2024 through Sep 10, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1356504096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 W LAYTON AVENUE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204364",
            "telephone_number": "414-281-3344",
            "fax_number": "414-281-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 W LAYTON AVENUE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204364",
            "telephone_number": "414-281-3344",
            "fax_number": "414-281-1080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOECKERMANN",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WI",
            "license": "5910-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Glad
• Amanda L Glorioso, RN BSN
• Thomas Louis Goddard, D.D.S.
• Paul Martin Godich
• Emily Goebert
• Drew J Goede, PT
• Rachael Goldmann, PSYD
• Jon Jay Golembiewski, RPH
• Tyler Golembiewski, PHARM.D.
• Anne Marie Gongola, D.P.T.

• Oral and Maxillofacial Surgery (Dentist) in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.