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General NPI Number Information
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NPI Number | 1639149834
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Entity Type | Individual
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Provider Name | SCOTT ROBBINS GOODOVE DDS
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 1127 FIRST COLONIAL RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2402
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Country | US
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Telephone | 757-412-2002
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Fax | 757-412-2003
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Provider Business Mailing Address
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Address Line | 837 FIRST COLONIAL RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6195
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Country | US
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Telephone | 757-412-2002
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Fax | 757-412-2003
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401410548
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4010548
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License Number State | VA
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