Ezra Goldberg-O'Neil, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0401417899 Issued in VA

Practice address

2125 McComas Way
Virginia Beach, VA 23456-3986

Phone

(757) 484-8262

NPI assigned

May 28, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric Dental Associates PLLC

  • Pediatric Dentistry
  • Williamsville, NY
  • NPI 1144730649
  NPD (past)
• University Pediatric Dentistry, P.C.

  • Pediatric Dentistry
  • Buffalo, NY
  • NPI 1649389560
  NPD (past)

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1689297350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 MAIN ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142092308",
            "telephone_number": "716-242-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 MCCOMAS WAY",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234563986",
            "telephone_number": "757-484-8262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Main St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142092308",
            "country_code": "US",
            "telephone_number": "716-242-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBERG-O'NEIL",
        "first_name": "EZRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "VA",
            "license": "0401417899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerel Lemar Goforth
• Goho Dental PLLC
• Stella Alice Goings, MD, MPH
• Ernest E. Goins, M.D.
• Aleksandra Gojkovic
• Jason Goldberg, M.D.
• Golden Age Guardian Care
• Golden Hartz ABA VA LLC
• Golden Healthcare Advantage Corp
• Stacey Morgan Goldfine, D.O.

• Pediatric Dentistry in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.