Nicholas George Goultas Jr., DDS, MPH, BS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104053 Issued in CA

Practice address

1261 E Hillsdale Blvd Ste 2
Foster City, CA 94404-1236

Phone

(650) 703-7451

NPI assigned

Jul 16, 2019

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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 and National Provider Directory roles.

• Nicholas Goultas, DDS, PC

  • Dental Clinic/Center
  • San Francisco, CA
  • NPI 1790474880
  NPD Authorized official

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1356994644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 WOODBRIDGE CIR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944034913",
            "telephone_number": "650-703-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 E HILLSDALE BLVD STE 2",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "944041236",
            "telephone_number": "650-703-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULTAS",
        "first_name": "NICHOLAS",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS, MPH, BS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jim Ghafourpour, DDS
• Hao Giang
• Samantha Justine Gilbert
• Gilead
• Sofi Gomez
• Nancy Meade Gray, M.ED., LMFT
• Zainab Hakim
• Philip Hampel
• Wanying Hao
• Paige Isabella Hardman

• General Practice Dentistry in Foster City, CA
• Providers in Foster City, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.