Opal Fay Goodridge, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

032832 Issued in NY

Practice address

227 Madison St
Medical Staff Affairs
New York, NY 10002-7537

Phone

(212) 238-7614

Fax

(212) 238-7009

NPI assigned

Jul 21, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Interoperability endpoints

• Direct secure messaging: ogoodridge676139@nychhc.direct-ci.com

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1891102034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 MADISON ST",
            "address_2": "MEDICAL STAFF AFFAIRS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027537",
            "telephone_number": "212-238-7614",
            "fax_number": "212-238-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 MADISON ST",
            "address_2": "MEDICAL STAFF AFFAIRS",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100027537",
            "telephone_number": "212-238-7614",
            "fax_number": "212-238-7009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODRIDGE",
        "first_name": "OPAL",
        "middle_name": "FAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "032832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "032832",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Elizabeth Goodnight, MS, RD, CDN
• Crystal Nicole Goodrich
• James Goodrich, MD
• Jessica Goodrich, DC
• Tara Goodrich, PHD
• Thomas Goodridge, M.ED
• Ann Ellen Goodstein, MPS, ATR-BC, LSAT
• Catherine Goodstein, MD
• Renee Goodstein, PH.D.
• Goodwerk & Company LLC

• Dentist in New York, NY
• Providers in New York, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.