John Gregory Dye, O.D.

Individual provider Active NPI Optometrist · West Fargo, ND

NPI 1003085523 · NPPES record last updated Nov 8, 2022

Key facts

NPI
1003085523
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
ND 378 (ND)
Practice address
1207 Prairie Pkwy
West Fargo, ND 58078-3145
Phone
(701) 282-2020
Fax
(701) 282-0230
NPI assigned
Feb 28, 2008
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
ND 378NDMDOptometrist
378NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic FHSC PC Current
since Jan 1, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ND 378 ND Yes

Addresses

Primary practice location

1207 Prairie Pkwy
West Fargo, ND 58078-3145

Mailing address

1207 Prairie Pkwy
West Fargo, ND 58078-3145
Phone (701) 282-2020

Other identifiers

IdentifierTypeStateIssuer
60533MedicaidND

Other providers in West Fargo, ND

All providers in West Fargo, ND · Optometrist in North Dakota

Sources for this page

Verify at the official NPI Registry.