Dane Troy Goodwin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12013491A Issued in IN

Practice address

1690 N Main St
Huntingburg, IN 47542-8973

Phone

(812) 683-1112

NPI assigned

Jun 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

• Kelly Family Dentistry, PC

  • General Practice Dentistry
  • Huntingburg, IN
  • NPI 1457620783

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1669031845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1690 N MAIN ST",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475428973",
            "telephone_number": "812-683-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 N MAIN ST",
            "city": "HUNTINGBURG",
            "state": "IN",
            "postal_code": "475428973",
            "telephone_number": "812-683-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "DANE",
        "middle_name": "TROY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11311862",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12013491A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Fischer, OD
• Alan Paul Friz, DDS
• Victoria R Gavin, PHARMD
• Adam James Gilbert, PT, DPT, COMT, CSCS
• Jenna N Gogel, D.C.
• Jamie Lynn Greenwell, DMD, MS, ABGD, FAGD
• Ava Ham
• Carolyn Hampton, LAT, ATC
• Anthony Jay Hautman
• Healthcare Centers of Indiana, LLC

• All providers in Huntingburg, IN
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.