DR. BRIAN JOSEPH GOODACRE (NPI# 1821519000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821519000 |
| Entity Type | Individual |
| Full Name | DR. BRIAN JOSEPH GOODACRE |
| Credential | DDS, MSD |
| Practice Address |
11092 Anderson St Loma Linda CA 92350-1706 |
| Practice Telephone | 9095584222 |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2017-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
62481 | CA | Dental Providers |
| Street Address |
11092 ANDERSON ST |
| City | LOMA LINDA |
| State | CA |
| Zip Code | 92350-1706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114912854 | Nathan Alexander Dinsbach | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2005-09-20 |
| 1134736366 | Mel-anizi Abante Bersaba | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2020-10-01 |
| 1205454683 | Marilyn Tago | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2020-07-11 |
| 1366095143 | Akinlolu Tolulope Jegede | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2019-07-19 |
| 1992360705 | Alexander Borisovich Zaykov | Student in an Organized Health Care Education/Training Program | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2019-05-07 |
| 1619450020 | Carlos Alberto Poni | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-09-11 |
| 1780175513 | Lin Jing | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-05-29 |
| 1336630177 | Roya Mahmoodi | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-05-29 |
| 1740771583 | Susan Q Xu | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-05-29 |
| 1881191872 | Janine Tran | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2018-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059010 | Stephanie Abandy | Student in an Organized Health Care Education/Training Program | 11262 Campus Street - West Hall, West Hall, Loma Linda, CA 92350 | 2020-03-23 |
| 1275911844 | Rosemarie Florian | Internal Medicine | 11234 Anderson St Rm 1503, Loma Linda, CA 92350 | 2015-05-14 |
| 1235525403 | Diana Derosa Villarreal | Pediatrics | 11175 Campus St. Cp-a1111, Department of Pediatrics, Loma Linda, CA 92350 | 2015-04-14 |
| 1609212919 | Daniel Eldridge Smith | Surgery | 11175 Campus St # 21111, Loma Linda, CA 92350 | 2013-05-14 |
| 1992057269 | Hildemar Feliciano Dos Santos | Nutritionist | 25040 Stewart Street, Loma Linda, CA 92350 | 2012-10-10 |
| 1184910762 | Kristyn Anne Mannoia | Surgery | 11234 Anderson Ave Ste 2100, Loma Linda, CA 92350 | 2011-06-22 |
| 1760774947 | Loma Linda University | Special Hospital | 1234 Anderson Street, Gme Office Csp 21005, Loma Linda, CA 92350 | 2011-05-06 |
| 1144547977 | Andrei Radulescu | Surgery | 11175 Campus St Ste 21111, Loma Linda, CA 92350 | 2010-05-04 |
| 1619102845 | Wing Sze Esther Yung | Surgery | 11175 Campus Street #21111, Loma Linda Universiy Healthcare System, Loma Linda, CA 92350 | 2009-05-18 |
| 1679720734 | Ronald Lee Young | Dentist | 11092 Anderson Streeet, Llu School of Dentistry, Loma Linda, CA 92350 | 2008-08-20 |
| Find all providers in zip 92350 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376878918 | Robert Douglas Walter | Dentist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2009-10-15 |
| 1063664621 | Wendy Christina Gregorius | Dentist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2008-10-15 |
| 1821249913 | Montry S. Suprono | Dentist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2008-10-07 |
| 1700036266 | John Boram Won | Dentist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2008-09-22 |
| 1326296427 | Vu Quoc Huynh | Dentist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2008-09-03 |
| 1821246166 | Nadim Z. Baba | Dentist | 11092 Anderson Street, Llu School of Dentistry, Loma Linda, CA 92350-0001 | 2008-08-28 |
| 1518157759 | Joseph Yun Kwang Kan | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2007-07-25 |
| 1750581260 | Jaime Lorencez Lozada | Dentist | 11092 Anderson St, Loma Linda, CA 92350-1706 | 2007-07-23 |
| 1174739346 | William Patrick Naylor | Dentist | 11092 Anderson Street, Loma Linda, CA 92354 | 2007-05-15 |
| 1497960348 | Myron Sheldon Winer | Dentist | 11092 Anderson Street, Loma Linda, CA 92354 | 2007-05-14 |
| Find all providers in LOMA LINDA | ||||
| City | LOMA LINDA |
| Zip Code | 92350 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.