Individual provider Active NPI

David L Goettee, D.D.S.

  • General Practice Dentistry
  • Kennesaw, GA
National Provider Identifier
1457405441
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN008184 Issued in GA
Practice address
5255 Stilesboro Rd NW
Suite 150
Kennesaw, GA 30152-7737
Phone
(770) 505-0929
Fax
(770) 794-2304
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN008184 GA Primary

Addresses

Primary practice location

5255 Stilesboro Rd NW
Suite 150
Kennesaw, GA 30152-7737

Mailing address

5255 Stilesboro Rd NW
Suite 150
Kennesaw, GA 30152-7737
Phone (770) 505-0929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN008184GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David L Goettee D.D.S., P.C. General Practice CurrentSince Mar 26, 2023 Accepting new patients

Locations

5255 Stilesboro Rd NW
Ste 150
Kennesaw, GA 30152
Phone (770) 505-0929

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1457405441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 STILESBORO RD NW",
            "address_2": "SUITE 150",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527737",
            "telephone_number": "770-505-0929",
            "fax_number": "770-794-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 STILESBORO RD NW",
            "address_2": "SUITE 150",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527737",
            "telephone_number": "770-505-0929",
            "fax_number": "770-794-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTEE",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN008184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.