Glen M Goldstein

Primary specialty

DentistTaxonomy code 122300000X

License

DI16078 Issued in NJ

Practice address

1243 Sussex Tpke
Randolph, NJ 07869-2997

Phone

(973) 895-7995

Fax

(973) 895-2332

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in NJ

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

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 and National Provider Directory roles.

• Randolph Dental Care

  • Dentist
  • Randolph, NJ
  • NPI 1487676920
  NPD (past) Authorized official

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1437172715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 SUSSEX TPKE",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692997",
            "telephone_number": "973-895-7995",
            "fax_number": "973-895-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 SUSSEX TPKE",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692997",
            "telephone_number": "973-895-7995",
            "fax_number": "973-895-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "GLEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI16078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina E. Rayfield, PH.D., PC
• Angela Marie Giordano, APN
• Meghan Mary Giusti
• Robert Gold, DMD
• Elisabeth Rachel Goldstein, M.D.
• Zachary Goldstein, DMD
• Kaitlin Dickert Gonzales, D.P.M
• Ricki L Gottlieb, M.D.
• Thomas J Grable, ATC, PTA
• Sara Grapski, NCSP

• Dentist in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; 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.