Individual provider Active NPI

Joelle Goggans, D.D.S

  • General Practice Dentistry
  • Atlanta, GA
National Provider Identifier
1477907707
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123308 Issued in GA
Practice address
465 Boulevard SE Ste 207a
Atlanta, GA 30312-3483
Phone
(404) 624-1230
NPI assigned
Apr 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN123308 GA Primary
General Practice Dentistry 1223G0001X 059199 NY

Addresses

Primary practice location

465 Boulevard SE Ste 207a
Atlanta, GA 30312-3483

Mailing address

465 Boulevard SE Ste 207a
Atlanta, GA 30312-3483

Other practice location 1

12750 Merit Dr Ste 1100
Dallas, TX 75251-1302
Phone (972) 361-0600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200928002940 NY Order and Referring Only - DentistPractitioner - Dentist 2961821756

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN123308GAMDGeneral Practice Dentistry
059199NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Parkway Dental Associates General Practice Past Accepting new patients
Professional Dental Alliance of Atlanta Boulevard SE, LLC Past Accepting new patients
Grant Park Dental Group PC General Practice Past Accepting new patients
Ira E Gronowitz DDS PC Past Accepting new patients

Organizations & group practices 4

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": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1477907707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 BOULEVARD SE STE 207A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 BOULEVARD SE STE 207A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123483",
            "telephone_number": "404-624-1230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12750 Merit Dr Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752511302",
            "country_code": "US",
            "telephone_number": "972-361-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOGGANS",
        "first_name": "JOELLE",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-22",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123308",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "059199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.