Wanda M Goldhush, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7330 Issued in VA

Practice address

1421 Prince St Ste 140
Alexandria, VA 22314-2771

Phone

(703) 549-1331

Fax

(703) 549-0480

NPI assigned

Nov 15, 2006

Last updated

Jul 16, 2020By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 26, 2017 through Jun 26, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Alexandria Old Town Dental PLLC

  • Dentist
  • Alexandria, VA
  • NPI 1518465939
  NPD

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1831261767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 PRINCE ST STE 140",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142771",
            "telephone_number": "703-549-1331",
            "fax_number": "703-549-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1421 PRINCE ST STE 140",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223142771",
            "telephone_number": "703-549-1331",
            "fax_number": "703-549-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDHUSH",
        "first_name": "WANDA",
        "middle_name": "M",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "7330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth A. Goldberg, OTR, CHT
• David Mitchell Goldberg, OD
• Lisa Goldberg, DO
• Melissa Faye Goldblatt, C.P.N.P.
• Goldhealthpro LLC
• Joel Gregory Goldman, M.D.
• Mark Golub, DDS
• Shirley Golub, LPC
• Karynn Suzette Gomes, NP-C
• Rosa M Gomes

• General Practice Dentistry in Alexandria, VA
• Providers in Alexandria, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.