Gregory Jay Dill, DDS
Individual provider Active NPI Dentist · Greenup, IL
NPI 1124184569 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124184569
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- Practice address
- 102 E Cumberland
Greenup, IL 62428-0818 - Phone
- (217) 923-5292
- Fax
- (217) 923-3682
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150520000010 | IL | Order and Referring Only - Oral Surgery |
9830419688 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019021796 | IL | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | IL | Yes |
Addresses
Primary practice location
102 E Cumberland
Greenup, IL 62428-0818
Mailing address
PO Box 818
102 E Cumberland
Greenup, IL 62428-0818
Phone (217) 923-5292
Other providers in Greenup, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.