Provider Demographics
NPI:1255508156
Name:GOLDBERG, STEVEN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:GOLDBERG
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 1:190 GOLDENS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2810
Mailing Address - Country:US
Mailing Address - Phone:914-232-8182
Mailing Address - Fax:914-232-0193
Practice Address - Street 1:190 GOLDENS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2810
Practice Address - Country:US
Practice Address - Phone:914-232-8182
Practice Address - Fax:914-232-0193
Is Sole Proprietor?:No
Enumeration Date:2008-05-11
Last Update Date:2008-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0288031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice