Ellen Goldberg, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI01509500 Issued in NJ

Practice address

1771 Madison Ave
Lakewood, NJ 08701

Phone

(732) 364-2144

Fax

(732) 534-8064

NPI assigned

Nov 20, 2009

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Interoperability endpoints

• Direct secure messaging: ellen.goldberg@chemed.eclinicaldirectplus.com

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1619205168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-364-2144",
            "fax_number": "732-534-8064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-364-2144",
            "fax_number": "732-534-8064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01509500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0220396",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madelaine Gold, LMFT
• Rachel Gold, COTA
• Yachat Malka Gold, RDN
• Aviva Goldberg
• Chana Goldberg, RDN
• Miriam Goldberg
• Miriam Bracha Goldberg
• Noah Goldberg
• Yehudis C Goldberg, SLP
• Zehava Goldberg

• General Practice Dentistry in Lakewood, NJ
• Providers in Lakewood, 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 May 23, 2013; 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.