NPIMap

Organization Active NPI

Dustin V. Goodwin D.D.S. P.C

  • General Practice Dentistry
  • Garland, UT
National Provider Identifier
1679679435
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D-3532 Issued in ID
Legal business name
DUSTIN V. GOODWIN D.D.S. P.C
Practice address
75 E 1400 S
Garland, UT 84312-9316
Phone
(435) 257-7016
Fax
(435) 257-4590
NPI assigned
Sep 16, 2006
Last updated
Jul 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Dr. Dustin Vinal Goodwin, D.D.S.NPI 1952784902
Title
President
Phone
(435) 257-7016

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D-3532 ID Primary

Addresses

Primary practice location

75 E 1400 S
Garland, UT 84312-9316

Mailing address

75 E 1400 S
PO Box 99
Garland, UT 84312-9316
Phone (435) 257-7016

Other identifiers 3

IdentifierTypeStateIssuer
806174600MedicaidID
1319810OtherUNITED CONCORDIA/TRICARE
6H429OtherBLUE CROSS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1679679435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 E 1400 S",
            "address_2": "PO BOX 99",
            "city": "GARLAND",
            "state": "UT",
            "postal_code": "843129316",
            "telephone_number": "435-257-7016",
            "fax_number": "435-257-4590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E 1400 S",
            "city": "GARLAND",
            "state": "UT",
            "postal_code": "843129316",
            "telephone_number": "435-257-7016",
            "fax_number": "435-257-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUSTIN V. GOODWIN D.D.S. P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "VINAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-257-7016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-3532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806174600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA/TRICARE",
            "identifier": "1319810",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "6H429",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.