Goodwine Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GOODWINE DENTAL, LLC

Practice address

210 E 91St St Ste a
Indianapolis, IN 46240-1570

Phone

(317) 818-7777

Fax

(317) 818-7779

NPI assigned

Aug 16, 2021

Organization subpart

No

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

Authorized official

Name

Ronda Richelle Cox

Title

Office Manager

Phone

(317) 818-7777

Specialties & licenses 1

Addresses

Other names 1

• Northview Dental Doing business as

Electronic endpoints 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brody Wayne Goodwine, DDS

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1659800134
  NPD
• John Michael Pasicznyk, D.D.S

  • Dentist
  • Bonita Springs, FL
  • NPI 1003127564
  NPD (past)

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1376218909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 91ST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401570",
            "telephone_number": "317-818-7777",
            "fax_number": "317-818-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 91ST ST STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401570",
            "telephone_number": "317-818-7777",
            "fax_number": "317-818-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWINE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-02",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "RICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "317-818-7777"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@indynorthviewdental.com",
            "affiliation": "N",
            "endpointDescription": "office email",
            "address_1": "210 E 91st St Ste A",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462401570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Northview Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Goodwill Education Initiatives Incorporated
• Goodwill Industries of Central Indiana
• Andrea Jo Goodwin, MSW
• Meredith Lauren Goodwin, PA-C
• Valerie Ann Goodwin, OT
• Brody Wayne Goodwine, DDS
• Gopi Krishn Gorantla
• Courtney Elese Gorbandt, CCC-SLP
• Gregory Gorden
• Katherine E. Gorden, RPH

• Dental Clinic/Center in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.