Individual provider Active NPI

Heather Adrianne Goldberger, D.D.S., M.B.A.

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1679590459
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
049305 Issued in NY
Practice address
32 Court St
Suite 301
Brooklyn, NY 11201-4404
Phone
(718) 625-4441
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 049305 NY Primary

Addresses

Primary practice location

32 Court St
Suite 301
Brooklyn, NY 11201-4404

Mailing address

8918 Shore CT
Brooklyn, NY 11209-5506
Phone (347) 492-0073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608001853 NY Order and Referring Only - DentistPractitioner - Dentist 0143510818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
049305NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1679590459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8918 SHORE CT",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112095506",
            "telephone_number": "347-492-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 COURT ST",
            "address_2": "SUITE 301",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014404",
            "telephone_number": "718-625-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERGER",
        "first_name": "HEATHER",
        "middle_name": "ADRIANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.B.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.