Individual provider Active NPI

Ashley Goss, D.D.S.

  • Pediatric Dentistry
  • Belmont, NC
National Provider Identifier
1922240969
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9165 Issued in NC
Practice address
420 Park St Ste 101
Belmont, NC 28012-3393
Phone
(704) 755-4600
NPI assigned
Apr 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 9165 NC Primary

Addresses

Primary practice location

420 Park St Ste 101
Belmont, NC 28012-3393

Mailing address

420 Park St Ste 101
Belmont, NC 28012-3393
Phone (704) 755-4600

Other identifiers 1

IdentifierTypeStateIssuer
5918220MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20150807013601 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8426362229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9165NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooke and Mvula, PLLC Pediatric Dentistry PastSince Oct 29, 2023 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": "1238976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1922240969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PARK ST STE 101",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280123393",
            "telephone_number": "704-755-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 PARK ST STE 101",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280123393",
            "telephone_number": "704-755-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSS",
        "first_name": "ASHLEY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-06",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "9165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918220",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, NC

Sources for this page

Verify at the official NPI Registry.