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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. MARK GOODENOUGH, DDS, MD

Active

DR. MARK GOODENOUGH, DDS, MD is a Oral & Maxillofacial Surgery (Physician) healthcare provider located in STATEN ISLAND, New York. NPI 1154858033 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery (Physician) · STATEN ISLAND, NY

Registration Details

NPI Number
1154858033
Provider Type
Individual
Gender
Male
NPI Issued
May 22, 2017 (9.1889680199694 yrs)
Last Updated
Jun 26, 2024
Licenses
063143 (NY)
311698 (NY)

Practice Information

Address
256C MASON AVE
STATEN ISLAND, NY, 103053408
Browse NY providers · Browse ZIP 10305
Phone
7182261251
Primary Specialty
Oral & Maxillofacial Surgery (Physician)
204E00000X
Additional Specialty
General Practice
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.