Barry J Goldberg, DMD MSCD
Individual provider Active NPI Endodontics · Boston, MA
NPI 1386798874 · NPPES record last updated Jun 25, 2019
Key facts
- NPI
- 1386798874
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endodontics 1223E0200X
- License
- 13336 (MA)
- Practice address
- 800 Boylston St Ste 200
Boston, MA 02199-8176 - Phone
- (617) 259-1100
- Fax
- (617) 536-6061
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Nov 7, 2017 through Nov 7, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13336 | MA | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Barry J Goldberg DMD PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 13336 | MA | Yes |
Addresses
Primary practice location
800 Boylston St Ste 200
Boston, MA 02199-8176
Mailing address
PO Box 590043
Newton Centre, MA 02459-0001
Phone (617) 244-4654
Other practice location 1
1400 Centre St Ste 103
Newton Centre, MA 02459-2414
Phone (617) 964-0063
Other practice location 2
1400 Centre St Ste 101A
Newton Centre, MA 02459-2415
Phone (617) 244-4871
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.