Gregory W Goodreau, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN13745 Issued in FL

Practice address

17350 Panama City Beach Pkwy
Panama City Beach, FL 32413-6039

Phone

(850) 230-3364

Fax

(850) 233-9434

NPI assigned

May 4, 2007

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Goodreau & Richardson Dentistry

  • General Practice Dentistry
  • Panama City Beach, FL
  • NPI 1669700589
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609088160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324136039",
            "telephone_number": "850-230-3364",
            "fax_number": "850-233-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324136039",
            "telephone_number": "850-230-3364",
            "fax_number": "850-233-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODREAU",
        "first_name": "GREGORY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "593484406",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LISCENSE #",
            "identifier": "DN13745",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Leah Goetz, RPH
• Golden Dynasty Rental Properties LLC
• Haley Golden
• Maria D Jesus Gonzalez Fuentes I
• Goodreau & Richardson Dentistry
• Britney Gore, APRN
• Kimberly Mills Gore
• Nancy Diane Granese, RN
• Great Florida Smiles & Orthodontics PBC, PLLC
• Janis Kay Green, ARNP

• General Practice Dentistry in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• General Practice Dentistry in Florida

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.