Provider Demographics
NPI:1992839450
Name:GOLDBERG, BARBARA LYNN (RDH)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 BEECHMONT TRL
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4782
Mailing Address - Country:US
Mailing Address - Phone:216-292-0596
Mailing Address - Fax:
Practice Address - Street 1:3930 BEECHMONT TRL
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4782
Practice Address - Country:US
Practice Address - Phone:216-292-0596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31005977124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist