Michael D Goodwin, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

7552 Issued in IN

Practice address

11045 Broadway
Suite B
Crown Point, IN 46307-7474

Phone

(219) 662-1200

Fax

(219) 662-1888

NPI assigned

Nov 16, 2007

Last updated

Nov 16, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1477734598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11045 BROADWAY",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077473",
            "telephone_number": "219-662-1200",
            "fax_number": "219-662-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11045 BROADWAY",
            "address_2": "SUITE B",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077474",
            "telephone_number": "219-662-1200",
            "fax_number": "219-662-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "7552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina Elsa Gonzalez
• Arianna Gonzalez
• Megan Gonzalez
• Crystal Goodlander
• Kayley Goodlink-Lukowski, RBT
• Arien Dakota Gordon
• Laura Graham, NP
• Cynthia Catherine Grass Black, L.C.S.W.
• Jessica Gray
• Michael Stephen Gray, PHARMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; 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.