Maxim Godko, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02643700 Issued in NJ

Practice address

100 Federal City Rd # 104B
Lawrenceville, NJ 08648-1664

Phone

(609) 718-7997

Fax

(888) 575-1408

NPI assigned

Aug 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Deluxe Dentistry LLC

  dba Deluxe Dentistry

  • Dental Clinic/Center
  • Lawrenceville, NJ
  • NPI 1902450224
  NPD Authorized official

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1558815365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 MONMOUTH RD",
            "address_2": "ROUTE 537",
            "city": "WRIGHTSTOWN",
            "state": "NJ",
            "postal_code": "085622125",
            "telephone_number": "609-758-2244",
            "fax_number": "609-758-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FEDERAL CITY RD # 104B",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086481664",
            "telephone_number": "609-718-7997",
            "fax_number": "888-575-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODKO",
        "first_name": "MAXIM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02643700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michala Glassman
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• Paul Edward Goldberg, M.D.
• Golden Age Treatment LLC
• Michael Scot Goldenberg, ATC
• Steven M Goldsmith, MD
• Natalya Golikova, RPH

• General Practice Dentistry in Lawrenceville, NJ
• Providers in Lawrenceville, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.