Fredric Ronald Googel, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4281 Issued in CT

Practice address

1268 Main St
Newington, CT 06111-3038

Phone

(860) 666-5674

NPI assigned

Jun 13, 2005

Sex

Male

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Jul 1, 2024 through Jul 1, 2028

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.

• Avon Oral and Maxillofacial Surgery, LLP

  • Oral and Maxillofacial Surgery (Dentist)
  • Avon, CT
  • NPI 1801013727
  NPD (past)

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619971066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 MAIN ST",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061113038",
            "telephone_number": "860-666-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 MAIN ST",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061113038",
            "telephone_number": "860-666-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOGEL",
        "first_name": "FREDRIC",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "4281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Gomes, PT, DPT, NCS
• Gregg Gomlinski, PT
• Jane Lynne Gonzalez, MSW
• Jodi Ann Goodson
• Lynne M. Goodwin, LMFT
• Shioban Natassia Gordon, LCSW
• Emily J Gorki Cruzeiro, ATC
• Christine Gozo, PT
• Rachel Gravel
• Luciane L Gray, LMSW

• Oral and Maxillofacial Surgery (Dentist) in Newington, CT
• Providers in Newington, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.