Thomas Louis Goddard, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5878 Issued in WI

Practice address

3033 W Layton Ave
Suite 203
Greenfield, WI 53221-2628

Phone

(414) 325-9300

NPI assigned

Apr 18, 2007

Sex

Male

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

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.

Opted out of Medicare

Yes, effective Apr 4, 2016 through Apr 4, 2028

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.

• Wisconsin Endodontic Group, S.C.

  • Endodontics
  • Wauwatosa, WI
  • NPI 1942450457
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1730305657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD",
            "address_2": "STE 240",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261306",
            "telephone_number": "414-258-1500",
            "fax_number": "414-258-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 W LAYTON AVE",
            "address_2": "SUITE 203",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212628",
            "telephone_number": "414-325-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODDARD",
        "first_name": "THOMAS",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": "5878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Gilles
• Michael F Girolami, M.D.
• Deanna M Giudice, M.S., SLP-CFY
• Susan Glad
• Amanda L Glorioso, RN BSN
• Paul Martin Godich
• Emily Goebert
• Robert John Goeckermann, DDS
• Drew J Goede, PT
• Rachael Goldmann, PSYD

• Endodontics in Greenfield, WI
• Providers in Greenfield, WI by specialty
• Endodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.