MEDICARE: JOELLE GOGGANS 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	DN123308	GA
2	1223G0001X	General Practice Dentistry	059199	NY

General Provider Information

NPI Number	:	1477907707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOELLE GOGGANS D.D.S

Provider Business Mailing Address
First Line	:	465 BOULEVARD SE STE 207A
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-3483
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 BOULEVARD SE STE 207A
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-3483
Country	:	US
Telephone Number	:	404-624-1230
Fax Number	:

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

Provider Enumeration Date	:	04/22/2016
Last Update Date	:	01/23/2026

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Directions to “ JOELLE GOGGANS D.D.S” Practice Location

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