Clifford T Goodwin, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6165 Issued in VA

Practice address

12515 Warwick Blvd Ste 203
Newport News, VA 23606-2964

Phone

(757) 930-3744

Fax

(757) 930-2726

NPI assigned

Jul 18, 2006

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 VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Clifford T. Goodwin, DDS

  dba a division of Atlantic Dental Care

  • Dentist
  • Newport News, VA
  • NPI 1073918165
  NPD (past) Authorized official

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1841219276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12610 PATRICK HENRY DR",
            "address_2": "STE G",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236029538",
            "telephone_number": "757-930-3355",
            "fax_number": "757-930-2726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12515 WARWICK BLVD STE 203",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062964",
            "telephone_number": "757-930-3744",
            "fax_number": "757-930-2726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "CLIFFORD",
        "middle_name": "T",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "6165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Lafayette Goode, RPH
• Colleen Michelle Goodly
• Andrew M Goodman, OD
• Charleton Yves-Marie B Goodman
• Debra Ann Goodman, CD(DONA)
• Kimberly Goodwin
• Lori M Goodwin, MD
• Rachel Goodwyn, LPC
• Rwanda Goolsby
• Gordon Wellness LLC

• Dentist in Newport News, VA
• Providers in Newport News, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.