Brian James Goodwine, DDS is a medicare enrolled "Dentist" provider in Monticello, Utah. His current practice location is
217 S 100 West, Monticello, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 587-2528.
Brian James Goodwine is licensed to practice in Utah (license number 3601859922) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1891857223.
Healthcare Provider's Profile
| Full Name | Brian James Goodwine |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 217 S 100 West, Monticello, Utah |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1891857223
- Provider Enumeration Date: 12/14/2006
- Last Update Date: 03/07/2022
Medicare PECOS Information:
- PECOS PAC ID: 1557657640
- Enrollment ID: I20160916000715
Medical Identifiers
Medical identifiers for Brian James Goodwine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1891857223 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 122300000X | Dentist | 3601858903 (Utah) | Secondary |
| 122300000X | Dentist | 3601859922 (Utah) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brian James Goodwine allows following entities to bill medicare on his behalf.
| Entity Name | Utah Navajo Health System Incorporated |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811991151
PECOS PAC ID: 1658275649
Enrollment ID: O20031121000239 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brian James Goodwine is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Brian James Goodwine, DDS
Po Box 130,
Montezuma Creek, UT 84534-0130
Ph: (435) 651-3700 | Brian James Goodwine, DDS
217 S 100 West,
Monticello, UT 84535
Ph: (435) 587-2528 |
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