Active NPI
Rachit Goyal, DMD
- Dentist
- Columbia, MO
National Provider Identifier
1851773055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2015019759
- Practice address
- 2901 W Broadway
Suite 109
Columbia, MO 65203-0499 - Phone
- (573) 445-5811
- Fax
- (573) 445-5819
- NPI assigned
- Jun 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 2015019759 | MO | Primary |
Addresses
Primary practice location
2901 W Broadway
Suite 109
Columbia, MO 65203-0499
Mailing address
2901 W Broadway
Suite 109
Columbia, MO 65203-0499
Phone (573) 445-5811
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015019759 | MO | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Cove Family Dental PLLC | Current | Accepting new patients | |
| Sedation Dental Oasis LLC | Current | Accepting new patients | |
| Missouri Dental Professionals, Richard Straus, DMD, PC | Past | Accepting new patients |
Locations
15614 S Harlem Ave
Ste A
Orland Park, IL 60462
Phone (708) 614-1111
10012 Calumet Ave
#B
Munster, IN 46321
Phone (219) 319-5159
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Orland Park, IL
- NPI 1972392751
-
- General Practice Dentistry
- Munster, IN
- NPI 1871453589
-
- General Practice Dentistry
- Columbia, MO
- NPI 1558669556
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1851773055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2901 W BROADWAY",
"address_2": "SUITE 109",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652030499",
"telephone_number": "573-445-5811",
"fax_number": "573-445-5819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 W BROADWAY",
"address_2": "SUITE 109",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652030499",
"telephone_number": "573-445-5811",
"fax_number": "573-445-5819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOYAL",
"first_name": "RACHIT",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-24",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2015019759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.