Individual provider Active NPI

Susanna Marie Goggin, DMD

  • Periodontics
  • Asheville, NC
National Provider Identifier
1487949053
Registry record updated Jun 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
9926 Issued in NC
Practice address
602 Alliance CT
Asheville, NC 28806-2338
Phone
(828) 665-4405
Fax
(828) 665-4407
NPI assigned
Jun 12, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9019 KY
Periodontics 1223P0300X 9926 NC Primary
Periodontics 1223P0300X 260121 NC

Addresses

Primary practice location

602 Alliance CT
Asheville, NC 28806-2338

Mailing address

602 Alliance CT
Asheville, NC 28806-2338
Phone (828) 665-4405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170120000033 NC Order and Referring Only - DentistPractitioner - Dentist 7911289343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
260121NCMDPeriodontist
9019KYMDPharmacist
9926NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1307836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435622400000",
    "number": "1487949053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 ALLIANCE CT",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288062338",
            "telephone_number": "828-665-4405",
            "fax_number": "828-665-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 ALLIANCE CT",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288062338",
            "telephone_number": "828-665-4405",
            "fax_number": "828-665-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGGIN",
        "first_name": "SUSANNA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-12",
        "last_updated": "2015-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9019",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "9926",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "260121",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.