Good Life Dental, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7079 Issued in NE

Legal business name

GOOD LIFE DENTAL, P.C.

Practice address

302 S Bailey Ave
North Platte, NE 69101-5407

Phone

(308) 532-0427

NPI assigned

Sep 23, 2015

Organization subpart

No

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

Authorized official

Name

Kate Wolford Wawrzynkiewicz, D.D.S.NPI 1538509617

Title

President

Phone

(308) 532-0427

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Comprehensive Family Dentistry, L.L.C. Former legal business name

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kate A Wolford Wawrzynkiewicz, DDS

  • Dentist
  • North Platte, NE
  • NPI 1538509617
  NPD (past) Authorized official
• Michael Allen Furmanski Sr., DDS

  • Dentist
  • North Platte, NE
  • NPI 1033109665
  NPD (past)

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1912376617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S BAILEY AVE",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S BAILEY AVE",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015407",
            "telephone_number": "308-532-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE DENTAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "WOLFORD WAWRZYNKIEWICZ",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "308-532-0427",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NE",
            "license": "7079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261QD0000X",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Family Dentistry, L.L.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Marie Ann Godfrey
• Raj K Goje, M.D.
• Mollie Jo Golden, O.D.
• Sophia Rene Gomez, PA-C
• Manuelita Fatima Gonzalez
• Gosnell Family Medicine, PC
• John A Gosnell, O.D.
• Wendy Jo Gosnell, MD
• Nikki Rae Gracey, P.T.
• Jamie Graf

• Dental Clinic/Center in North Platte, NE
• Providers in North Platte, NE by specialty
• Dental Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.