Dr. Greg a. Roberts P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

1451579924 Issued in UT

Legal business name

DR. GREG A. ROBERTS P.C.

Practice address

5742 S 1475 E Ste 100
Ogden, UT 84403-4857

Phone

(801) 479-9070

Fax

(801) 479-9078

NPI assigned

Jan 4, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Greg A Roberts, DDSNPI 1356358535

Title

Oral & Maxillofacial Surgeon

Phone

(801) 479-9070

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Greg A. Roberts, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Ogden, UT
  • NPI 1356358535
  Medicare reassignment NPD Authorized official
• Shaun Thomas Heward, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • South Ogden, UT
  • NPI 1366826224
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1053596429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5742 S 1475 E STE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034857",
            "telephone_number": "801-479-9070",
            "fax_number": "801-479-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5742 S 1475 E STE 100",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034857",
            "telephone_number": "801-479-9070",
            "fax_number": "801-479-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GREG A. ROBERTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-04",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ORAL & MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "801-479-9070",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "1451579924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI TYPE 1",
            "identifier": "1356358535",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529989109028",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greg D Doxey, D.C.
• Thomas T Doxey, DC
• Dr Lorell Fawson DPM
• Dr. Calvin'S Clinic of Ogden
• Dr. Dale a. Woodfield and Associates, LLC
• Dr. Kim Graf, PC
• Dr. Matthew Miller, DDS
• Tim Drake, PHARMD
• Elise Maurine Draper
• Mary Ford Draper, D.D.S.

• Oral and Maxillofacial Surgery (Dentist) in Ogden, UT
• Providers in Ogden, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.