Provider Demographics
NPI:1669663241
Name:GOLDSCHEIN, DAVID JASON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JASON
Last Name:GOLDSCHEIN
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 1:2333 W CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1718
Mailing Address - Country:US
Mailing Address - Phone:813-251-5740
Mailing Address - Fax:
Practice Address - Street 1:2333 W CYPRESS ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1718
Practice Address - Country:US
Practice Address - Phone:813-251-5740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN178671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice