MEDICARE: VIKAS GOEL, DMD PLLC

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	034303	NY
2	1223G0001X	General Practice Dentistry	057920	NY
3	1223G0001X	General Practice Dentistry
4	1223G0001X	General Practice Dentistry	053611	NY

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

General Provider Information

NPI Number	:	1396056008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIKAS GOEL, DMD PLLC

Provider Business Mailing Address
First Line	:	132 ALBANY ST
Second Line	:	STE M3
City	:	CAZENOVIA
State	:	NY
Zip	:	13035-1231
Country	:	US
Telephone Number	:	315-655-5885
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 CHENANGO ST
Second Line	:
City	:	CAZENOVIA
State	:	NY
Zip	:	13035-1400
Country	:	US
Telephone Number	:	315-655-5885
Fax Number	:	866-591-3451

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VIKAS GOEL
Credential	:	DMD
Telephone Number	:	315-655-5885

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	02/26/2019

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