Jonathan J Golab, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18916 Issued in TX

Practice address

3020 Broadmoor LN Ste 100
Flower Mound, TX 75022-2705

Phone

(469) 444-2119

Fax

(972) 691-8269

NPI assigned

Apr 2, 2007

Last updated

Jan 23, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1881715753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 BROADMOOR LN",
            "address_2": "STE. 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222703",
            "telephone_number": "972-691-1700",
            "fax_number": "972-691-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 BROADMOOR LN STE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750222705",
            "telephone_number": "469-444-2119",
            "fax_number": "972-691-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLAB",
        "first_name": "JONATHAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Givens, FNP-C
• Brian Dale Glaser, D.O.
• Shannon Diane Glaser, RPH
• GND Operating, LLC
• Haley Goerlich
• Megan Joelle Gold, PT
• Jennifer Golden
• Peter T Gonyeau, DC
• Leandro Gonzales Jr., LSA
• Sahvannah Gonzalez, APRN

• General Practice Dentistry in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.