Michael L. Gold, D.M.D.
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Meridian, ID
NPI 1669645388 · NPPES record last updated Apr 3, 2008
Key facts
- NPI
- 1669645388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- D-3489-OR (ID)
- Practice address
- 1550 E Heritage Park St
Suite 100
Meridian, ID 83646-5886 - Phone
- (208) 884-5556
- Fax
- (208) 884-4041
- NPI assigned
- Apr 3, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-3489-OR | ID | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gold Orthodontics, P.C. | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | D-3489-OR | ID | Yes |
Addresses
Primary practice location
1550 E Heritage Park St
Suite 100
Meridian, ID 83646-5886
Mailing address
1550 E Heritage Park St
Suite 100
Meridian, ID 83646-5886
Phone (208) 884-5556
Other providers in Meridian, ID
- Eric Reid Goettsche
- Taylor Golay
- Gold Carriage LLC
- Gold Orthodontics, P.C.
- Chad Gold
- Marcel Alexander Goldberg
- Andrea Goldberger
- Golden Angel Residential Assisted Living
- Carolyn Suzanne Golden
- Olyvia J Golleher
All providers in Meridian, ID · Orthodontics and Dentofacial Orthopedics Dentistry in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 3, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.