Individual provider Active NPI

Michael Philip Golka, DDS

  • Endodontics
  • Fredericksburg, VA
National Provider Identifier
1679786107
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
05081 Issued in VA
Practice address
413 Chatham Square Office Park
Fredericksburg, VA 22405-2561
Phone
(540) 371-8444
Fax
(540) 371-8459
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 05081 VA Primary

Addresses

Primary practice location

413 Chatham Square Office Park
Fredericksburg, VA 22405-2561

Mailing address

413 Chatham Square Office Park
Fredericksburg, VA 22405-2561
Phone (540) 371-8444

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

State licenses

LicenseStateTypeSpecialty
05081VAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679786107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052561",
            "telephone_number": "540-371-8444",
            "fax_number": "540-371-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052561",
            "telephone_number": "540-371-8444",
            "fax_number": "540-371-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLKA",
        "first_name": "MICHAEL",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "05081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

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.

Verify at the official NPI Registry.