Eric Reid Goettsche, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D5000 Issued in ID

Practice address

53 E Calderwood Dr # 110
Meridian, ID 83642-7440

Phone

(208) 501-8860

Fax

(208) 501-8862

NPI assigned

Jul 9, 2015

Last updated

Jul 11, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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.

• 208 Dental

  • General Practice Dentistry
  • Meridian, ID
  • NPI 1356945539
  NPD Authorized official

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1851774723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 E CALDERWOOD DR # 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427440",
            "telephone_number": "208-501-8860",
            "fax_number": "208-501-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 E CALDERWOOD DR # 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427440",
            "telephone_number": "208-501-8860",
            "fax_number": "208-501-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTSCHE",
        "first_name": "ERIC",
        "middle_name": "REID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D5000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen A Glynn, BA
• Devin Theodore Gneiting, DMD
• Goals for Autism, Inc.
• Godspeed One LLC (Godspeed Wellness)
• Brianne Elizabeth Goettsche, RDH
• Taylor Golay, MS, RDN, LD
• Gold Carriage LLC
• Gold Orthodontics, P.C.
• Chad Gold, LPC
• Michael L. Gold, D.M.D.

• General Practice Dentistry in Meridian, ID
• Providers in Meridian, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.