Individual provider Active NPI

Daniel Brian Goldberg, D.D.S.

  • Dentist
  • Saint Louis, MO
National Provider Identifier
1437594280
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2013017100 Issued in MO
Practice address
555 N New Ballas Rd
Suite 355
Saint Louis, MO 63141-6825
Phone
(314) 567-3555
NPI assigned
May 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2013017100 MO Primary

Addresses

Primary practice location

555 N New Ballas Rd
Suite 355
Saint Louis, MO 63141-6825

Mailing address

555 N New Ballas Rd
Suite 355
Saint Louis, MO 63141-6825
Phone (314) 567-3555

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20150603001933 MO Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 2466773320

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dalin Dental Associates Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1437594280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N NEW BALLAS RD",
            "address_2": "SUITE 355",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416825",
            "telephone_number": "314-567-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N NEW BALLAS RD",
            "address_2": "SUITE 355",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416825",
            "telephone_number": "314-567-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "DANIEL",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-07",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2013017100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.