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General NPI Number Information
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NPI Number | 1588879530
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Entity Type | Organization
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Legal Business Name | DAVID B. GOODMAN D.D.S. , STEPHEN A. FESTA D.D.D.
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Dates
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Enumeration Date | 05/13/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3755 76TH ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6507
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Country | US
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Telephone | 718-429-6116
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Fax | 718-429-0843
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Provider Business Mailing Address
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Address Line | 3755 76TH ST
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-6507
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Country | US
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Telephone | 718-429-6116
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Fax | 718-429-0843
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Authorized Official
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Title or Position | PARTNER
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Name | DR. STEPHEN ANTHONY FESTA
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Credential | D.D.S.
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Telephone | 718-429-6116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 34936
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 26422
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 040213
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License Number State | NY
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