Individual provider Active NPI

Oscar Glenn Goodhand III, DDS, MAGD

  • General Practice Dentistry
  • McLean, VA
National Provider Identifier
1770641292
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5664 Issued in VA
Practice address
6870 Elm St
McLean, VA 22101-3893
Phone
(703) 748-1900
NPI assigned
Dec 5, 2006
Last updated
May 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5664 VA Primary

Addresses

Primary practice location

6870 Elm St
McLean, VA 22101-3893

Mailing address

10851 Deborah Dr
Potomac, MD 20854-2716
Phone (301) 520-7002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230114000165 MO Practitioner - Dentist 3577934330 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5664VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Health Services, Inc CurrentSince Jan 9, 2023 Accepting new patients
Northwest Health Services Inc Current Accepting new patients
Northwest Health Services Inc CurrentSince Jan 9, 2023 Accepting new patients

Locations

1303 State St
Mound City, MO 64470
Phone (660) 442-5464

3608 Faraon St
Saint Joseph, MO 64506
Phone (816) 232-4417

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464652800000",
    "number": "1770641292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10851 DEBORAH DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542716",
            "telephone_number": "301-520-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6870 ELM ST",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "221013893",
            "telephone_number": "703-748-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODHAND",
        "first_name": "OSCAR",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS, MAGD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "5664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

Verify at the official NPI Registry.