Active NPI
Bruce Eric Golder, DDS
- General Practice Dentistry
- Grass Valley, CA
National Provider Identifier
1508076035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 27621
- Practice address
- 404 S Auburn St
Grass Valley, CA 95945-7226 - Phone
- (530) 477-7944
- Fax
- (530) 477-7950
- NPI assigned
- May 23, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 27621 | CA | Primary |
Addresses
Primary practice location
404 S Auburn St
Grass Valley, CA 95945-7226
Mailing address
13509 Halls CT
Penn Valley, CA 95946-9166
Phone (530) 432-4758
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27621 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508076035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13509 HALLS CT",
"city": "PENN VALLEY",
"state": "CA",
"postal_code": "959469166",
"telephone_number": "530-432-4758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 S AUBURN ST",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959457226",
"telephone_number": "530-477-7944",
"fax_number": "530-477-7950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDER",
"first_name": "BRUCE",
"middle_name": "ERIC",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "27621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.