Active NPI
Kelly Goeckner
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cary, NC
National Provider Identifier
1790177756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 9296
- Practice address
- 1505 SW Cary Pkwy
Cary, NC 27511-6219 - Phone
- (919) 249-4900
- NPI assigned
- Feb 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 9296 | NC | Primary |
Addresses
Primary practice location
1505 SW Cary Pkwy
Cary, NC 27511-6219
Mailing address
1692 Miller Ave
Ann Arbor, MI 48103-2548
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425081600000",
"number": "1790177756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1692 MILLER AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481032548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 SW CARY PKWY",
"city": "CARY",
"state": "NC",
"postal_code": "275116219",
"telephone_number": "919-249-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOECKNER",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-28",
"last_updated": "2015-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NC",
"license": "9296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.