Provider Demographics
NPI:1861416026
Name:GOLDSTEIN, NEIL M (DDS)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:M
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 OFFICE PARK WAY
Mailing Address - Street 2:TOBEY VILLAGE OFFICE PARK
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1734
Mailing Address - Country:US
Mailing Address - Phone:585-348-9132
Mailing Address - Fax:
Practice Address - Street 1:30 OFFICE PARK WAY
Practice Address - Street 2:TOBEY VILLAGE OFFICE PARK
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1734
Practice Address - Country:US
Practice Address - Phone:585-348-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0358911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice