Goldberg, Kenneth M

Goldberg, Kenneth M is an individual health care provider with primary practice located at 201 N College Drive Suite 202, Santa Maria CA 93454. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Goldberg, Kenneth M can be contacted via phone (805) 928-7611.

Contact Information

Primary practice address
201 N College Drive Suite 202 Santa Maria CA 93454
Phone: (805) 928-7611
Fax: (805) 349-8551
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DI018568 New Jersey
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 59459 California

Profile Details

NPI number 1326036120
LBN Legal business name Goldberg, Kenneth M
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Jul 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326036120 NPPES
New Jersey MEDICAID 7056508

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