Provider Demographics
NPI:1679628945
Name:GOLDENBAUM, KIMBERLY SARA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:SARA
Last Name:GOLDENBAUM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:SARA
Other - Last Name:SILVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:20 NORTH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016
Mailing Address - Country:US
Mailing Address - Phone:908-276-2076
Mailing Address - Fax:
Practice Address - Street 1:20 NORTH AVE W
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-5114
Practice Address - Country:US
Practice Address - Phone:908-276-2076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02244700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist