Tiffany Michelle Goldwyn, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8145 Issued in OR

Practice address

1616 SW Sunset Blvd
Suite B
Portland, OR 97239-2641

Phone

(503) 244-8112

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tiffany Goldwyn DMD PC

  • General Practice Dentistry
  • Portland, OR
  • NPI 1316540826
  NPD Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1396835450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SW SUNSET BLVD",
            "address_2": "STE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392641",
            "telephone_number": "503-421-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 SW SUNSET BLVD",
            "address_2": "SUITE B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392641",
            "telephone_number": "503-244-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDWYN",
        "first_name": "TIFFANY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8145",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8145",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Samuel Goldstein, M.A.
• Michael J Goldstein, MD
• Kimberly Goldstien, MSW, LCSW
• Charles Brian Goldston, DC
• David Adam Goldwyn, DDS
• Traja G Golightly
• Rebecca Jennie Mae Golik
• Kathryn Gollier
• Tara Jeanne Golliher, LMT
• Irina Golovin

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.