Myron B Goldberg, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DSO20079SL Issued in PA

Practice address

1528 Walnut St
Suite 1725
Philadelphia, PA 19102-3604

Phone

(215) 732-0505

Fax

(215) 732-8744

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in PA

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

Medicare enrollment (NPD)

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.

• Dr. Myron B. Goldberg, D.D.S.

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1134432909
  NPD (past) Authorized official

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1710026554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 MOUNT VERNON ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303235",
            "telephone_number": "215-236-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 WALNUT ST",
            "address_2": "SUITE 1725",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191023604",
            "telephone_number": "215-732-0505",
            "fax_number": "215-732-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MYRON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DSO20079SL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Bruce Goldberg, M.D.
• Marc Stewart Goldberg, M.D.
• Mark King Goldberg, D.P.M.
• Marybeth Goldberg
• Melvyn Goldberg, M.D.
• Rachel Goldberg
• Risa Goldberg
• Robert Goldberg, D.D.S.
• Robert Andrew Goldberg, MD
• Sandra M. Goldberg, M.S., R.P.T.

• Dentist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.