# L RENEE GOODWIN DDS INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568643948
- **Authorized official:** DR. LEAH R GOODWIN DDS (OWNER)
- **Authorized official phone:** (812) 745-4151

## Contact information

- **Practice address:** 100 N. BROADWAY STREET, OAKTOWN, IN 47561-0269
- **Practice address phone:** (812) 745-4151
- **Practice address fax:** (812) 745-4152
- **Mailing address:** PO BOX 269, 100 N. BROADWAY STREET, OAKTOWN, IN 47561-0269
- **Mailing address phone:** (812) 745-4151
- **Mailing address fax:** (812) 745-4152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010355A | IN | Yes |

## Other

- **Enumeration date:** 11/14/2007
- **Last updated:** 04/06/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200357310 | — | IN |
| 05 | — | 200418020 | — | IN |
| 05 | — | 200435290 | — | IN |