MEDICARE: ROBERT GOLIGHTLY DDS, PC

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	261QD0000X	Dental Clinic/Center

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	:	1831738632
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT GOLIGHTLY DDS, PC

Provider Business Mailing Address
First Line	:	3712 90TH ST APT 1
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7862
Country	:	US
Telephone Number	:	718-429-5550
Fax Number	:	718-429-5556

Provider Business Practice Location Address
First Line	:	3712 90TH ST APT 1
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7862
Country	:	US
Telephone Number	:	718-429-5550
Fax Number	:	718-429-5556

Authorized Official
Title or Position	:	GENERAL DENTIST
Name	:	DR. ROBERT GOLIGHTLY JR.
Credential	:	DDS
Telephone Number	:	917-659-9575

Provider Enumeration Date	:	12/27/2019
Last Update Date	:	09/30/2025

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