Gordon Gardner Goldstine, DDS
Individual provider Active NPI General Practice Dentistry · Freedom, CA
NPI 1992218481 · NPPES record last updated Nov 7, 2017
Key facts
- NPI
- 1992218481
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DDS101836 (CA)
- Practice address
- 256 Green Valley Rd
Freedom, CA 95019-3139 - Phone
- (831) 722-4666
- NPI assigned
- Nov 7, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS101836 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terry F. Haskin, D.D.S., Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DDS101836 | CA | Yes |
Addresses
Primary practice location
256 Green Valley Rd
Freedom, CA 95019-3139
Mailing address
256 Green Valley Rd
Freedom, CA 95019-3139
Phone (831) 722-4666
Other providers in Freedom, CA
- Edgar Gamboa
- Lucie N. Gamboa
- Debra Garcia
- Vanessa Garnica
- Generations Health Care for Women a Medical Corporation
- Alexander Leonard Gordon
- Maria Sembrano Granthom
- Green Valley Laser, LLC
- Gilbert J Grio
- Marc L Grossman
All providers in Freedom, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2017. 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.