Donald Jean Goudreau III, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS041513 Issued in PA

Practice address

1003 W Baltimore Pike
Media, PA 19063

Phone

(484) 444-2793

NPI assigned

Jun 4, 2013

Last updated

Oct 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Amara Dental of Monroe, P.a.

  • General Practice Dentistry
  • Monroe, NJ
  • NPI 1689162372
  NPD (past)
• Sadi NJ, P.C.

  dba Smart Arches Monroe

  • Dental Clinic/Center
  • Monroe TWP, NJ
  • NPI 1609614015
  NPD (past)

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1477990182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190632332",
            "telephone_number": "484-444-2793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "484-444-2793"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Applegarth Rd",
            "address_purpose": "LOCATION",
            "city": "Monroe Township",
            "state": "NJ",
            "postal_code": "088313844",
            "country_code": "US",
            "telephone_number": "732-561-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOUDREAU",
        "first_name": "DONALD",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-04",
        "last_updated": "2024-10-03",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02956000",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Medical Plus LLC
• Daniel Delano Gordon Sr.
• Karen Christel Goren, LCSW, CGP
• Olivia Gorski, OTR/L
• Goshen Homecare Services LLC
• Bryan Gouge, MA
• Raymond Gould
• Jennifer Hurley Graber, LCSW
• Marc Alexander Gramatges, PSYD, ABPP, CBIS
• Vanessa Grandinetti

• General Practice Dentistry in Media, PA
• Providers in Media, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.