Active NPI
Michael Anthony Goodwin, DDS
- Dentist
- Flower Mound, TX
National Provider Identifier
1649526955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 27996
- Practice address
- 1005 Long Prairie Rd
Suite 100
Flower Mound, TX 75022-4241 - Phone
- (972) 538-3700
- NPI assigned
- Jul 24, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 27996 | TX | Primary |
Addresses
Primary practice location
1005 Long Prairie Rd
Suite 100
Flower Mound, TX 75022-4241
Mailing address
1005 Long Prairie Rd
Suite 100
Flower Mound, TX 75022-4241
Phone (972) 538-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150611000379 | TX | Order and Referring Only - Oral Surgery | 1153642459 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1469404800000",
"number": "1649526955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 LONG PRAIRIE RD",
"address_2": "SUITE 100",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750224241",
"telephone_number": "972-538-3700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 LONG PRAIRIE RD",
"address_2": "SUITE 100",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750224241",
"telephone_number": "972-538-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODWIN",
"first_name": "MICHAEL",
"middle_name": "ANTHONY",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-24",
"last_updated": "2016-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "27996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flower Mound, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.