Provider Demographics
NPI:1992968861
Name:GOLDENBERG, ROBERT BARRY (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BARRY
Last Name:GOLDENBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 E VIA DE VENTURA
Mailing Address - Street 2:202
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3323
Mailing Address - Country:US
Mailing Address - Phone:480-948-4445
Mailing Address - Fax:
Practice Address - Street 1:8600 E VIA DE VENTURA
Practice Address - Street 2:202
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3323
Practice Address - Country:US
Practice Address - Phone:480-948-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist