MEDICARE: MARK H GOLDENBERG DDS A DENTAL CORP DARRIN J HIRT DDS MS INC

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	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1861324881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARK H GOLDENBERG DDS A DENTAL CORP DARRIN J HIRT DDS MS INC

Provider Business Mailing Address
First Line	:	414 N CAMDEN DR STE 675
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-4518
Country	:	US
Telephone Number	:	310-271-5231
Fax Number	:

Provider Business Practice Location Address
First Line	:	3075 BEACON BLVD
Second Line	:
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-3462
Country	:	US
Telephone Number	:	916-702-1213
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	AYREN ENGELHARDT
Credential	:
Telephone Number	:	530-919-8661

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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