Christine Bryanne Goodell, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10413484 Issued in UT

Practice address

7632 S Campus View Dr Ste 150
West Jordan, UT 84084-5545

Phone

(801) 282-4142

NPI assigned

Jul 14, 2014

Last updated

Dec 12, 2017By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

• West Jordan Modern Dentistry , LLP

  dba West Jordan Modern Dentistry and Orthodontics

  • General Practice Dentistry
  • West Jordan, UT
  • NPI 1508134412
  NPD (past) Authorized official

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1750798542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7632 S CAMPUS VIEW DR STE 150",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845545",
            "telephone_number": "801-282-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7632 S CAMPUS VIEW DR STE 150",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845545",
            "telephone_number": "801-282-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODELL",
        "first_name": "CHRISTINE",
        "middle_name": "BRYANNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "00202266",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "10413484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cathy J Gonzales, FNP
• Alejandra Gonzalez, COTA/L
• Claudia L Gonzalez
• Good Shepherd Homecare and Hospice of Utah LLC (Good Shepherd Homecare & Hospice)
• Good Shepherd Medical Group
• Leslie L Goodwin, MD
• Crystal Miquel Gordon
• Janna Gordon, PHD
• Madison Gordon
• Robert Gorski Jr.

• General Practice Dentistry in West Jordan, UT
• Providers in West Jordan, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; 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.