Individual provider Active NPI

Amanda Golshiri

  • Dentist
  • Newark, DE
National Provider Identifier
1740635002
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
G0001400 Issued in DE
Practice address
300 Biddle Ave Ste 204
Newark, DE 19702-3972
Phone
(302) 428-4850
NPI assigned
Apr 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X G1-0001400 DE
Dentist 122300000X G0001400 DE Primary

Addresses

Primary practice location

300 Biddle Ave Ste 204
Newark, DE 19702-3972

Mailing address

300 Biddle Ave Ste 204
Newark, DE 19702-3972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20160801002646 DE Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1355634122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G0001400DEMDDentist
G1-0001400DEMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1740635002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BIDDLE AVE STE 204",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BIDDLE AVE STE 204",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197023972",
            "telephone_number": "302-428-4850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLSHIRI",
        "first_name": "AMANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-24",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "G1-0001400",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G0001400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

Verify at the official NPI Registry.