Healthcare Provider Details

I. General information

NPI: 1972237501
Provider Name (Legal Business Name): AUNDREA GOODMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 CECIL AVE
DELANO CA
93215-1716
US

IV. Provider business mailing address

815 CECIL AVE
DELANO CA
93215-1716
US

V. Phone/Fax

Practice location:
  • Phone: 661-545-7910
  • Fax:
Mailing address:
  • Phone: 501-612-5843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDDS109941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: