Individual provider Active NPI

Brian Steven Goldfarb, DMD, MSD

  • Periodontics
  • Scottsdale, AZ
National Provider Identifier
1457903387
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D011354 Issued in AZ
Practice address
4910 E Greenway Rd Ste 2
Scottsdale, AZ 85254-1653
Phone
(602) 404-4458
NPI assigned
Jul 11, 2019
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X D011354 AZ Primary

Addresses

Primary practice location

4910 E Greenway Rd Ste 2
Scottsdale, AZ 85254-1653

Mailing address

4910 E Greenway Rd # Set2
Scottsdale, AZ 85254-1653
Phone (215) 595-3305

Other practice location 1

1425 S Greenfield Rd Ste 110
Mesa, AZ 85206-5505
Phone (480) 564-4963

Other practice location 2

485 S Dobson Rd Ste 204
Chandler, AZ 85224-5604
Phone (480) 564-4954

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
D011354AZMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Pete N Mellas DMD Ms PLLC Periodontics PastSince Jul 17, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1457903387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 E GREENWAY RD # SET2",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852541653",
            "telephone_number": "215-595-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 E GREENWAY RD STE 2",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852541653",
            "telephone_number": "602-404-4458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 S Greenfield Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852065505",
            "country_code": "US",
            "telephone_number": "480-564-4963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "485 S Dobson Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852245604",
            "country_code": "US",
            "telephone_number": "480-564-4954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDFARB",
        "first_name": "BRIAN",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-11",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D011354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.