Active NPI
Liya Goitom, DDS
- Dentist
- Elkridge, MD
National Provider Identifier
1912215856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14610
- Practice address
- 6020 Meadowridge Center Dr
Suite a
Elkridge, MD 21075-6088 - Phone
- (410) 799-1793
- NPI assigned
- Sep 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 14610 | MD | Primary |
Addresses
Primary practice location
6020 Meadowridge Center Dr
Suite a
Elkridge, MD 21075-6088
Mailing address
2861 Strauss Ter
Silver Spring, MD 20904-7146
Phone (240) 605-6464
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 |
|---|---|---|---|
| 14610 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LGM DDS LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383696000000",
"number": "1912215856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2861 STRAUSS TER",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209047146",
"telephone_number": "240-605-6464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6020 MEADOWRIDGE CENTER DR",
"address_2": "SUITE A",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210756088",
"telephone_number": "410-799-1793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOITOM",
"first_name": "LIYA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-14",
"last_updated": "2013-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "14610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkridge, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.