Active NPI
Meredith Kristin Goodrich, D.M.D.
- Dentist
- Lake City, FL
National Provider Identifier
1902894652
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN16117
- Practice address
- 255 SW Main Blvd
Lake City, FL 32025-7050 - Phone
- (386) 752-2480
- NPI assigned
- Oct 7, 2005
- Sex
- Female
- Sole proprietor
- No
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 | DN16117 | FL | Primary |
Addresses
Primary practice location
255 SW Main Blvd
Lake City, FL 32025-7050
Mailing address
PSC 47 Box 67
Apo, AE 09470
Phone 011441480812826
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 |
|---|---|---|---|
| DN16117 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Melanie Holden, DMD, PLLC | Dentist | Past | Accepting new patients |
| Johann Ramkissoon, PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Lake City, FL
- NPI 1710497862
-
- Dentist
- Lake City, FL
- NPI 1205187143
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233792000000",
"number": "1902894652",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "PSC 47 BOX 67",
"city": "APO",
"state": "AE",
"postal_code": "09470",
"telephone_number": "011441480812826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 SW MAIN BLVD",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320257050",
"telephone_number": "386-752-2480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODRICH",
"first_name": "MEREDITH",
"middle_name": "KRISTIN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-07",
"last_updated": "2009-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN16117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.