Individual provider Active NPI

Rivka Goldenhersh, DMD

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1932405792
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2010025826 Issued in MO
Practice address
819 University PL
Saint Louis, MO 63132-5021
Phone
(314) 918-5921
NPI assigned
Jan 26, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2010025826 MO Primary

Addresses

Primary practice location

819 University PL
Saint Louis, MO 63132-5021

Mailing address

819 University PL
Saint Louis, MO 63132-5021
Phone (314) 918-5921

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20170112003344 MO Practitioner - Oral Surgery 3072895713 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2010025826MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Special Care Dental of Missouri LLC CurrentSince Dec 10, 2016 Accepting new patients
Rivka Goldenhersh, D.M.D., LLC General Practice Past Accepting new patients

Locations

12910 Shelbyville Rd
Louisville, KY 40243

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

1024 Adams St
Jefferson Cty, MO 65101
Phone (573) 635-1320

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.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1932405792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 UNIVERSITY PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631325021",
            "telephone_number": "314-918-5921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 UNIVERSITY PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631325021",
            "telephone_number": "314-918-5921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDENHERSH",
        "first_name": "RIVKA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-26",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2010025826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.