Dr Wendy Goodman, DDS is a medicare enrolled "Dentist - Periodontics" provider in Leesberg, Florida. Her current practice location is
949 N 14th St, Leesberg, Florida. You can reach out to her office (for appointments etc.) via phone at
(352) 460-0164.
Dr Wendy Goodman is licensed to practice in Florida (license number DN23123) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1053574087.
Healthcare Provider's Profile
| Full Name | Dr Wendy Goodman |
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| Gender | Female |
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| Speciality | Dentist - Periodontics |
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| Location | 949 N 14th St, Leesberg, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1053574087
- Provider Enumeration Date: 07/09/2008
- Last Update Date: 01/16/2019
Medicare PECOS Information:
- PECOS PAC ID: 4284988957
- Enrollment ID: I20181115001018
Medical Identifiers
Medical identifiers for Dr Wendy Goodman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053574087 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | DN23123 (Florida) | Secondary |
| 1223P0300X | Dentist - Periodontics | 035239 (New York) | Secondary |
| 1223P0300X | Dentist - Periodontics | DN23123 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Wendy Goodman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Wendy Goodman, DDS
2756 Cutters Cor,
The Villages, FL 32162-6038
Ph: (352) 973-2007 | Dr Wendy Goodman, DDS
949 N 14th St,
Leesberg, FL 34748
Ph: (352) 460-0164 |
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