Nicholas Goultas, DDS, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NICHOLAS GOULTAS, DDS, PC

Doing business as

Island Dental

Practice address

5011 Geary Blvd Ste a
San Francisco, CA 94118-2880

Phone

(650) 703-7451

NPI assigned

May 4, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas George Goultas Jr., DDS, MPHNPI 1356994644

Title

Ceo

Phone

(650) 703-7451

Specialties & licenses 1

Addresses

Other names 1

• Island Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas George Goultas Jr., DDS, MPH, BS

  • General Practice Dentistry
  • Foster City, CA
  • NPI 1356994644
  NPD Authorized official

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1790474880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 POLK ST APT 107",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941093013",
            "telephone_number": "650-703-7451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 GEARY BLVD STE A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941182880",
            "telephone_number": "650-703-7451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS GOULTAS, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "GOULTAS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-703-7451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS, MPH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Cheng-Feng Ni, MD
• Lin Ni
• Danielle Niakaros
• Elena Marie San Juan Nicdao, OTR/L
• Eric Shawn Nicely, PSYD
• Theodora K. Nicholau, MD
• Haden Patrick Nicholl
• Allison Jean Nicholls, M.S. CCC-SLP
• Fred Herbert Nicholls, MD
• Tim Nicholls, M.D.

• Dental Clinic/Center in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.