Active NPI
David Goldberg, DDS, MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Highland Park, IL
National Provider Identifier
1487007696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 019029576
- Practice address
- 332 Skokie Valley Rd
Suite 222
Highland Park, IL 60035-4415 - Phone
- (847) 831-1100
- NPI assigned
- Jul 22, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 019029576 | IL | Primary |
Addresses
Primary practice location
332 Skokie Valley Rd
Suite 222
Highland Park, IL 60035-4415
Mailing address
1010 W Monroe St
Apt 4
Chicago, IL 60607-3399
Phone (218) 209-8027
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019029576 | IL | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469145600000",
"number": "1487007696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 W MONROE ST",
"address_2": "APT 4",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606073399",
"telephone_number": "218-209-8027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 SKOKIE VALLEY RD",
"address_2": "SUITE 222",
"city": "HIGHLAND PARK",
"state": "IL",
"postal_code": "600354415",
"telephone_number": "847-831-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "DAVID",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-22",
"last_updated": "2016-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "IL",
"license": "019029576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Highland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.