Wanda Frances Goodreau, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN13875 Issued in FL

Practice address

1415 Governors Square Blvd
Tallahassee, FL 32301-3049

Phone

(850) 583-5748

NPI assigned

Apr 29, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831333228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 SHADY OAKS LN",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324443098",
            "telephone_number": "850-819-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 GOVERNORS SQUARE BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323013049",
            "telephone_number": "850-583-5748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 Southwood Dr",
            "address_purpose": "LOCATION",
            "city": "Panama City",
            "state": "FL",
            "postal_code": "324054905",
            "country_code": "US",
            "telephone_number": "850-769-2424",
            "fax_number": "950-769-9199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODREAU",
        "first_name": "WANDA",
        "middle_name": "FRANCES",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN0013875",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney J Goodman, MS, CCC-SLP
• Garrett Craige Goodman, APRN-C
• Howell Stewart Goodman Jr., PHARM. D
• Maria Goodman
• Betty Jean Goodpasture, ARNP
• Angela Goodson, RN, IBCLC
• Gracelyn J. Goodwin, COTA/L
• Jade Goodwin
• Stacy Goody, ARNP
• Kartik Gopal, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.