NPIMap

Organization Active NPI

Dr. Leonard Goldman, PA

  • Oral and Maxillofacial Surgery Clinic/Center
  • Silver Spring, MD
National Provider Identifier
1376892018
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
8392 Issued in MD
Legal business name
DR. LEONARD GOLDMAN, PA
Practice address
12510 Prosperity Dr
Suite 250
Silver Spring, MD 20904-1663
Phone
(301) 622-2700
NPI assigned
Sep 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Authorized official

Name
Dr. Leonard Jay Goldman, D.D.S.NPI 1639267172
Title
President
Phone
(301) 622-2700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 8392 MD Primary

Addresses

Primary practice location

12510 Prosperity Dr
Suite 250
Silver Spring, MD 20904-1663

Mailing address

12510 Prosperity Dr
Suite 250
Silver Spring, MD 20904-1663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120913000100 DC Part B Supplier - Clinic/Group Practice 3779731971 Receives reassigned benefits from 1 practitioner
Practice locations: Silver Spring, MD

National Provider Directory

National Provider Directory

Locations

12510 Prosperity Dr
Ste 250
Silver Spring, MD 20904
Phone (301) 622-2700

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1346976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346976000000",
    "number": "1376892018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 PROSPERITY DR",
            "address_2": "SUITE 250",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12510 PROSPERITY DR",
            "address_2": "SUITE 250",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041663",
            "telephone_number": "301-622-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LEONARD GOLDMAN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-07",
        "last_updated": "2012-09-07",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-622-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "8392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.