Jeffrey Paul Godber, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D0408 Issued in SD

Practice address

700 Sheridan Lake Rd
Rapid City, SD 57702-2407

Phone

(605) 341-3068

Fax

(605) 341-5757

NPI assigned

Nov 9, 2006

Last updated

Jul 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Black Hills Pediatric Dentistry

  • Pediatric Dentistry
  • Rapid City, SD
  • NPI 1194867499
  NPD (past)
• Black Hills Pediatric Dentistry

  • Community Health Worker
  • Rapid City, SD
  • NPI 1538889738
  NPD (past)

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1538239900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SHERIDAN LAKE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022407",
            "telephone_number": "605-341-3068",
            "fax_number": "605-341-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SHERIDAN LAKE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022407",
            "telephone_number": "605-341-3068",
            "fax_number": "605-341-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODBER",
        "first_name": "JEFFREY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY 946",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D0408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120229100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0408",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100249748-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean A Gliedt-Peter, LPC
• Heidi Ann Glood, CNP
• GN Hearing Care Corp (Beltone Hearing Care Center)
• Kimberly J. Goble, M.D.
• David Godbe
• Marissa Godfrey
• Randee Goetsch
• Corby Katharina Goetzinger
• Emilee Goldy
• Briana Goley, RN

• General Practice Dentistry in Rapid City, SD
• Providers in Rapid City, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.