MEDICARE: DR. ELIZABETH S GOLDMAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	16962	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	16962	OTHER	TX	CHIP NUMBER

General Provider Information

NPI Number	:	1538381702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH S GOLDMAN D.D.S.

Provider Business Mailing Address
First Line	:	1575 REDBUD BLVD
Second Line	:	SUITE 103
City	:	MCKINNEY
State	:	TX
Zip	:	75069-3226
Country	:	US
Telephone Number	:	214-585-0268
Fax Number	:	214-585-0284

Provider Business Practice Location Address
First Line	:	1575 REDBUD BLVD
Second Line	:	SUITE 103
City	:	MCKINNEY
State	:	TX
Zip	:	75069-3226
Country	:	US
Telephone Number	:	214-585-0268
Fax Number	:	214-585-0284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	10/24/2022

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Directions to “ DR. ELIZABETH S GOLDMAN D.D.S.” Practice Location

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