Mark Andrew Goldberg, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

16344 Issued in FL

Practice address

1603 S Hiawassee Rd
Suite 135
Orlando, FL 32835-6438

Phone

(407) 293-8324

Fax

(407) 298-7810

NPI assigned

Mar 9, 2010

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 FL

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.

• Coast Florida P.a.

  • Dentist
  • Tampa, FL
  • NPI 1730287673
  NPD (past)
• Coast Florida P.a.

  • Dentist
  • Orlando, FL
  • NPI 1811563133
  NPD (past)

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1790008415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SW 27TH AVE",
            "address_2": "APT. 1701",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331335307",
            "telephone_number": "954-328-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 S HIAWASSEE RD",
            "address_2": "SUITE 135",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356438",
            "telephone_number": "407-293-8324",
            "fax_number": "407-298-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "MARK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "16344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffry P Gold, AGNP-C
• Brian Keith Goldberg, M.D.
• Dorie E Goldberg, PA
• Joshua M Goldberg, M.D.
• Lawrence Mark Goldberg, LCSW
• Paul A Goldberg
• Golden Care Chiropractic LLC
• Golden Carriage Retirement Home
• Golden Carriage Retirement Home I Inc
• Golden Cove Assisted Living Facility, Inc

• Endodontics in Orlando, FL
• Providers in Orlando, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.