Scott Ira Goldberg, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

19610 Issued in MA

Practice address

17 Bridge St.
Suite 204
Billerica, MA 01821

Phone

(978) 663-3476

Fax

(978) 663-2537

NPI assigned

Jan 1, 2007

Sex

Male

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

Enrolled in MA

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.

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 and National Provider Directory roles.

• Sleep Well Live Well PLLC

  • Customized Equipment (DME)
  • Billerica, MA
  • NPI 1184183667
  NPD (past) Authorized official

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1871650945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BRIDGE ST.",
            "address_2": "SUITE 204",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "01821",
            "telephone_number": "978-663-3476",
            "fax_number": "978-663-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BRIDGE ST.",
            "address_2": "SUITE 204",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "01821",
            "telephone_number": "978-663-3476",
            "fax_number": "978-663-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "SCOTT",
        "middle_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-01",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19610",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "19610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen L Friedman
• William Douglas Gammon, PH.D.
• Jillian Marie Gay
• Melissa Gilgun
• Anne Frances Gleason, D.C.
• Isabella Golden
• Joan Esther Goldman, PHD
• Richard Alan Goldman, OD
• Valerie Grams, RN
• Grateful Dentists

• Dentist in Billerica, MA
• Providers in Billerica, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.