Nisa Goshtasbi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022665 Issued in MI

Practice address

50505 Schoenherr Rd Ste 170
Shelby Township, MI 48315-3141

Phone

(586) 803-8300

NPI assigned

Jun 11, 2018

Last updated

Jun 11, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pointe Family Dentistry Washington

  dba Pointe Dental Group

  • General Practice Dentistry
  • Washington TWP, MI
  • NPI 1144172305
  NPD (past)
• Pointe Family Dentistry-Shelby PLLC

  • Dentist
  • Shelby TWP, MI
  • NPI 1083947162
  NPD (past)
• University of Detroit Mercy

  • Health Maintenance Organization
  • Royal Oak, MI
  • NPI 1376095273
  NPD (past)

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1396238887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 PARMENTER BLVD APT 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480731339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50505 SCHOENHERR RD STE 170",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153141",
            "telephone_number": "586-803-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSHTASBI",
        "first_name": "NISA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Anne Gonzalez, LPC
• Krismen Gooden
• Brian Lawrence Goodwin, DPM
• Amanda Jean Gordon, OTRL,CLT-UE,CKTP
• Jodie Elizabeth Gordon, O.D.
• Rachel Lyn Gosselin, LMSW
• Vanessa Ryan Gosselin
• Carlton Gould
• Grace Community Hospice Care, LLC
• Cyd Charisse Grace, MA,LLPC,LBSW

• General Practice Dentistry in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.