Casey Goettlicher

Primary specialty

DentistTaxonomy code 122300000X

License

2901021989 Issued in MI

Practice address

37595 7 Mile Rd
#450
Livonia, MI 48152-1003

Phone

(734) 855-4474

NPI assigned

Jul 6, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1962854745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37595 7 MILE RD",
            "address_2": "#450",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37595 7 MILE RD",
            "address_2": "#450",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521003",
            "telephone_number": "734-855-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETTLICHER",
        "first_name": "CASEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-06",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962854745",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Robert Gluck, D.D.S.
• Sara Goburdhun, PHD
• Vijay Goburdhun, MD
• Ajey V Godbole, M.D.
• Douglas Goebel, CCP
• Victoria Golas, DO
• Rachel Morgan Goldberg
• Golden Home Health Care, Inc.
• Steven B Goldenthal, MD
• Izik Goldman, DO

• Dentist in Livonia, MI
• Providers in Livonia, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.