Greenfield Periodontics LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12011410A Issued in IN

Legal business name

GREENFIELD PERIODONTICS LLC

Practice address

120 W McKenzie Rd
Ste J
Greenfield, IN 46140-1072

Phone

(317) 477-3000

Fax

(317) 477-3002

NPI assigned

May 3, 2016

Last updated

May 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Julie Combs, DDS MSNPI 1194056697

Title

Owner

Phone

(317) 477-3000

Specialties & licenses 1

Addresses

Other names 1

• Greenfield Periodontics and Implant Dentistiry Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julie Lynn Combs, DDS MS

  • Periodontics
  • Greenfield, IN
  • NPI 1194056697
  Authorized official Same address or phone

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1053766501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 W MCKENZIE RD",
            "address_2": "STE J",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401072",
            "telephone_number": "317-477-3000",
            "fax_number": "317-477-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MCKENZIE RD",
            "address_2": "STE J",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401072",
            "telephone_number": "317-477-3000",
            "fax_number": "317-477-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENFIELD PERIODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-477-3000",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12011410A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenfield Periodontics and Implant Dentistiry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mary Greenwalt
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• Periodontics in Greenfield, IN
• Providers in Greenfield, IN by specialty
• Periodontics in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.