Martin B. Goldstein, D.M.D.
Individual provider Active NPI General Practice Dentistry · Wolcott, CT
NPI 1952426041 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1952426041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 020005280CT01 (CT)
- Practice address
- 464 Wolcott Rd
Wolcott, CT 06716-2626 - Phone
- (203) 879-4649
- Fax
- (203) 879-5560
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5280 | CT | MD | Professional Counselor |
| 020005280CT01 | CT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 020005280CT01 | CT | Yes |
Addresses
Primary practice location
464 Wolcott Rd
Wolcott, CT 06716-2626
Mailing address
464 Wolcott Rd
Wolcott, CT 06716-2626
Phone (203) 879-4649
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- Jeffrey Gonzalez
- Marrhonda Goodwin
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All providers in Wolcott, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.