Provider Type Icon

DR. DONALD JEAN GOUDREAU D.M.D. NPI 1477990182


NPI Information

NPI: 1477990182
Provider Name: DR. DONALD JEAN GOUDREAU, D.M.D.
Classification: Dentist - 1223S0112X
Entity Type: Individual

Specialization: Oral and Maxillofacial Surgery

PECOS Registration: Yes

Address:
245 N 15TH ST
MAIL STOP MS 467, ROOM 7318
PHILADELPHIA, PA
ZIP 19102
Phone: (215) 762-5630
Get Directions

DR. Donald Jean Goudreau, D.M.D. is an oral and maxillofacial surgery dentist in Philadelphia, PA. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. DR. Donald Jean Goudreau, D.M.D. NPI is 1477990182. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

245 N 15TH ST
MAIL STOP MS 467, ROOM 7318
PHILADELPHIA, PA
ZIP 19102-192
Phone: (215) 762-5630
Fax: (215) 762-8389

The NPI 1477990182 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 6/4/2013 and was last updated on 6/4/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryUNKNOWN AT THIS TIMEPENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.