Active NPI
Monica Goldenberg, DDS MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Georgetown, TX
National Provider Identifier
1669536736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 18960
- Practice address
- 3007 Dawn Dr
Suite 103
Georgetown, TX 78628 - Phone
- (512) 863-8580
- Fax
- (512) 366-9694
- NPI assigned
- Dec 21, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 18960 | TX | Primary |
Addresses
Primary practice location
3007 Dawn Dr
Suite 103
Georgetown, TX 78628
Mailing address
3007 Dawn Drive
Suite 103
Georgetown, TX 78628
Phone (512) 863-8580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18960 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669536736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3007 DAWN DRIVE",
"address_2": "SUITE 103",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "78628",
"telephone_number": "512-863-8580",
"fax_number": "512-366-9694"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3007 DAWN DR",
"address_2": "SUITE 103",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "78628",
"telephone_number": "512-863-8580",
"fax_number": "512-366-9694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDENBERG",
"first_name": "MONICA",
"name_prefix": "Mrs.",
"credential": "DDS MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "18960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.