Michelle Goodman, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DN 21912 Issued in FL

Practice address

41B State St
Lynn, MA 01901-1504

Phone

(781) 292-4319

NPI assigned

Jun 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942650817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 COMMERCIAL ST. UNIT 534",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41B STATE ST",
            "city": "LYNN",
            "state": "MA",
            "postal_code": "019011504",
            "telephone_number": "781-292-4319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 Blanding Blvd Ste 6B",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735065",
            "country_code": "US",
            "telephone_number": "904-276-5950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "MICHELLE",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 21912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miguel A Gonzalez, RN
• Ira Gooch, MA
• Gregory Michael Good
• Mary Ellen Gooding-Call, LMHC
• Mark C Goodman
• Marcus T Gordon, M.D.
• Zoe Gordon
• Theresa Goretti
• Ryan Gosselin, M.D., M.B.A
• James M Gottschall, MD

• Dentist in Lynn, MA
• Providers in Lynn, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.