Individual provider Active NPI

Mark J Geary, DMD

  • General Practice Dentistry
  • Rock Hill, SC
National Provider Identifier
1164546453
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4060 Issued in SC
Practice address
1562 Constitution Blvd
Suite 103
Rock Hill, SC 29732-3004
Phone
(803) 324-7686
Fax
(803) 324-5344
NPI assigned
Mar 19, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4060 SC Primary

Addresses

Primary practice location

1562 Constitution Blvd
Suite 103
Rock Hill, SC 29732-3004

Mailing address

1562 Constitution Blvd
Suite 103
Rock Hill, SC 29732-3004
Phone (803) 324-7686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140429000603 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8729211768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4060SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Murdoch Dental General Practice Past Accepting new patients
Murdoch & Geary Dental General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164546453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1562 CONSTITUTION BLVD",
            "address_2": "SUITE 103",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323004",
            "telephone_number": "803-324-7686",
            "fax_number": "803-324-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 CONSTITUTION BLVD",
            "address_2": "SUITE 103",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297323004",
            "telephone_number": "803-324-7686",
            "fax_number": "803-324-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEARY",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "4060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.