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Deactivated NPI 1164595237 Deactivated / Inactive NPI Male Practitioner

Dr. Perry Jay Goldberg , DDS

Dentist - General Practice • Syosset, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Perry Goldberg has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 16, 2006
NPI Deactivation Date November 06, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Perry Goldberg, DDS was a registered Dentist - General Practice practicing in Syosset, NY. Throughout an active medical career spanning 19 years, Dr. Goldberg provided care at the practice location at 175 JERICHO TPKE until profile deactivation on 2025-11-06.

Practice Location & Contact Primary Location

Practice Address

175 Jericho Tpke
Suite 115a

Syosset, NY 117914595

Telephone 5163642550
Fax 5163642551
Associated Practice Facility / Clinic
🏢 Vasctech, Inc. Facility NPI 1326095811

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Syosset, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.2 Yrs
Regional Practice Density
24 Specialists

Practicing in Syosset, NY (8411 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NY 027523

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Robert Fasano , LMSW

Social Worker - Clinical

NPI 1013190495

Licensed Master Social Worker

NPI 1043206923

Doctor of Podiatric Medicine

Mark Kahn

Internal Medicine

NPI 1134443112
Dr. Marianne Young , MD

Internal Medicine

NPI 1144329772

Doctor of Medicine (M.D.)

Dr. Fredric Mintz , MD

Internal Medicine

NPI 1194759530

Doctor of Medicine (M.D.)

Dr. Darren Mollick , MD

Dermatology - MOHS-Micrographic Surgery

NPI 1225012552

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 06, 2025

Record deactivated on November 06, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 175 JERICHO TPKE, SUITE 115A, SYOSSET, NY 117914595 (Tel: 5163642550)

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Updated Business Mailing Address July 08, 2007

Registered at 175 JERICHO TPKE, SUITE 115A, SYOSSET, NY 117914595 (Tel: 5163642550)

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Provider Name / Credentials Updated July 08, 2007

Recorded as PERRY GOLDBERG, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #027523 in NY)

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Initial NPI Registration & Enumeration November 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164595237
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2006
Last Update: July 08, 2007
Deactivation Date: November 06, 2025

Mailing Address

175 Jericho Tpke, Suite 115a

Syosset, NY 117914595

Phone: 5163642550

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.