Rachel Samantha Goldberg, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019029960 Issued in IL

Practice address

2 E Rollins Rd
Suite 202
Round Lake Beach, IL 60073-3808

Phone

(847) 546-5550

NPI assigned

Aug 22, 2014

Last updated

Aug 22, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zieba Dentistry Round Lake Beach, LTD.

  dba Reilly & Siegel Family Dental

  • Dental Clinic/Center
  • Round Lake Beach, IL
  • NPI 1992279467
  NPD (past)

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

{
    "created_epoch": "1408665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1700285079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E ROLLINS RD",
            "address_2": "SUITE 202",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600733808",
            "telephone_number": "847-546-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E ROLLINS RD",
            "address_2": "SUITE 202",
            "city": "ROUND LAKE BEACH",
            "state": "IL",
            "postal_code": "600733808",
            "telephone_number": "847-546-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "RACHEL",
        "middle_name": "SAMANTHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-22",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019029960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fundamentals Pediatric Therapy and Consulting Inc.
• Laura Galan
• Emily Gierut, L.M.T
• Katherine L Gilman
• Leonard Ginzburg, M.D.
• Greenleaf Orthopaedic Associates S C
• Jocelyn Grubb, RDH
• Elizabeth A Haeffele, LCSW
• Danielle Halton
• Miles Hang, D.O.

• Dentist in Round Lake Beach, IL
• Providers in Round Lake Beach, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.