Provider Demographics
NPI:1932592482
Name:JOSEPH E GOLDING JR DDS
Entity Type:Organization
Organization Name:JOSEPH E GOLDING JR DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOLDING
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:812-376-8610
Mailing Address - Street 1:3240 MIDDLE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4426
Mailing Address - Country:US
Mailing Address - Phone:812-376-8610
Mailing Address - Fax:812-376-7743
Practice Address - Street 1:3240 MIDDLE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4426
Practice Address - Country:US
Practice Address - Phone:812-376-8610
Practice Address - Fax:812-376-7743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009758122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200175360Medicaid