Provider Demographics
NPI:1194980581
Name:RICHARD E. GOLDSTEIN, DDS, PC
Entity type:Organization
Organization Name:RICHARD E. GOLDSTEIN, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-399-9300
Mailing Address - Street 1:165 W 46TH ST
Mailing Address - Street 2:STE. 1115
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-2501
Mailing Address - Country:US
Mailing Address - Phone:212-399-9300
Mailing Address - Fax:212-333-5188
Practice Address - Street 1:165 W 46TH ST
Practice Address - Street 2:STE. 1115
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-2501
Practice Address - Country:US
Practice Address - Phone:212-399-9300
Practice Address - Fax:212-333-5188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty