Individual
DR. JONATHAN F GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
CT7211
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0146671003
CIGNA
CT
01
—
0146671004
CIGNA
CT
01
—
020007211CT03
BLUE CROSS BLUE SHIELD
CT
01
—
020007211CT04
BLUE CROSS BLUE SHIELD
CT
01
—
190000684
PTAN
CT
01
—
4227283
AETNA
CT
01
—
750677
CONNECTICARE
CT
01
—
83982
AETNA
CT
01
—
P1274198
OXFORD
CT
Enumeration date
06/27/2006
Last updated
03/05/2015
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