Gregory Charles Pedro, DMD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DS028828L Issued in PA

Practice address

560 Van Reed Rd
Suite 201
Wyomissing, PA 19610-1799

Phone

(610) 373-5559

Fax

(610) 373-5125

NPI assigned

Jun 19, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1124289491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 VAN REED RD",
            "address_2": "SUITE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101799",
            "telephone_number": "610-373-5559",
            "fax_number": "610-373-5125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 VAN REED RD",
            "address_2": "SUITE 201",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101799",
            "telephone_number": "610-373-5559",
            "fax_number": "610-373-5125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRO",
        "first_name": "GREGORY",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "PA",
            "license": "DS028828L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthodontics in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Prosthodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.