Individual provider Active NPI

Glenn David Goldstein, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Somerset, NJ
National Provider Identifier
1558489336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DI13180 Issued in NJ
Practice address
1527 Route 27
Suite 2200
Somerset, NJ 08873-3979
Phone
(732) 249-6800
Fax
(732) 249-6835
NPI assigned
Mar 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DI13180 NJ Primary

Addresses

Primary practice location

1527 Route 27
Suite 2200
Somerset, NJ 08873-3979

Mailing address

1527 Route 27
Suite 2200
Somerset, NJ 08873-3979
Phone (732) 249-6800

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

LicenseStateTypeSpecialty
DI13180NJMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558489336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 ROUTE 27",
            "address_2": "SUITE 2200",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733979",
            "telephone_number": "732-249-6800",
            "fax_number": "732-249-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1527 ROUTE 27",
            "address_2": "SUITE 2200",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088733979",
            "telephone_number": "732-249-6800",
            "fax_number": "732-249-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "GLENN",
        "middle_name": "DAVID",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "DI13180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

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.

Verify at the official NPI Registry.