David Adam Goldwyn, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D8010 Issued in OR

Practice address

2350 SW Multnomah Blvd
Portland, OR 97219-3999

Phone

(503) 245-0180

Fax

(503) 452-3634

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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 OR

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

Practice roles

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.

• David a. Goldwyn, DDS, PC

  • Periodontics
  • Portland, OR
  • NPI 1972666956
  NPD (past) Authorized official

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962496315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 SW MULTNOMAH BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193999",
            "telephone_number": "503-245-0180",
            "fax_number": "503-452-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 SW MULTNOMAH BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972193999",
            "telephone_number": "503-245-0180",
            "fax_number": "503-452-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDWYN",
        "first_name": "DAVID",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D8010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Goldstein, RN
• Kerry Samuel Goldstein, M.A.
• Michael J Goldstein, MD
• Kimberly Goldstien, MSW, LCSW
• Charles Brian Goldston, DC
• Tiffany Michelle Goldwyn, DMD
• Traja G Golightly
• Rebecca Jennie Mae Golik
• Kathryn Gollier
• Tara Jeanne Golliher, LMT

• Periodontics in Portland, OR
• Providers in Portland, OR by specialty
• Periodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.