DR. JEREMY CLARK GOODSON D.D.S.
NPI 1720375223
Dentist in Oklahoma City, OK

Q: What is Jeremy Goodson's NPI number?

The NPI number for Jeremy Goodson is 1720375223. It was assigned to this individual provider in the NPPES registry on July 5, 2011.

Q: What is Jeremy Goodson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Jeremy Goodson enrolled in Medicare?

No. Jeremy Goodson has opted out of Medicare through April 3, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Jeremy Goodson was last updated on July 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 05, 2011Opted out of Medicare · through Apr 3, 2028

4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120(405) 755-4826(405) 755-9096 Get Directions Write a Review

NPPES record last updated: July 1, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Jeremy Clark Goodson D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JEREMY CLARK GOODSON D.D.S. (NPI 1720375223) is an individual dentist in Oklahoma City, Oklahoma, licensed in Oklahoma (6314) and active in the NPI registry since July 2011. He has opted out of Medicare through April 3, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1720375223

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. JEREMY CLARK GOODSONCredential: D.D.S.

Location Address4320 MCAULEY BLVDOklahoma City, OK 73120

Mailing Address4320 Mcauley BlvdOklahoma City, OK 73120 · (405) 755-4826 · Fax (405) 755-9096

Phone(405) 755-4826

Fax(405) 755-9096

Sole ProprietorNo

Enumeration DateJuly 5, 2011

Last NPPES UpdateJuly 1, 2015

✔ NPI 1720375223 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in OK · 6314

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

4320 MCAULEY BLVD, Oklahoma City, OK 73120

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Jeremy Clark Goodson D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 3, 2018 through April 3, 2028.

Opt-Out Effective DateApril 3, 2018

Opt-Out In Effect ThroughApril 3, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 73120 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.46 typical visit price

range $53.00 – $162.61

Typical copayment $20.61 (range $13.25 – $40.65)

Most-billed visit code 99203

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER LYNNE WALKER DDS

Dentist