Walter A Goodell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901011046 Issued in MI

Practice address

600 E Grand River Ave
Suite 4a
Brighton, MI 48116-1983

Phone

(810) 227-2121

Fax

(810) 227-0961

NPI assigned

May 31, 2007

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

Other names 1

• Walter A Goodell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962604207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 N NICHOLSON RD",
            "city": "FOWLERVILLE",
            "state": "MI",
            "postal_code": "488368290",
            "telephone_number": "810-227-2121",
            "fax_number": "810-227-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E GRAND RIVER AVE",
            "address_2": "SUITE 4A",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161983",
            "telephone_number": "810-227-2121",
            "fax_number": "810-227-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODELL",
        "first_name": "WALTER",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901011046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WALTER",
            "last_name": "GOODELL",
            "middle_name": "A",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lee Kevin Gold, DPM
• Alan David Goldberg, MB,CHB
• Marc Goldman, LMSW, LCSW
• Maria Golemo, PHARMD
• Ciarra Nichole Gombert
• Samantha Ann Goodenow, MD
• Gwen Goodrow, MD
• Stephanie Lynn Goodson, MD
• Geraldine Gordon, MSW
• Laura J Gordon, LLP

• All providers in Brighton, MI
• General Practice Dentistry in Michigan

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.