Oak Grove Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OAK GROVE DENTAL ASSOCIATES, LLC

Practice address

1640 Main St
Green Bay, WI 54302-2639

Phone

(920) 468-6371

Fax

(920) 468-6365

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Scott Robert Greatens, D.D.S.NPI 1932226503

Title

Managing Partner

Phone

(920) 468-6371

Specialties & licenses 1

Addresses

Practitioners 2

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

• Scott Robert Greatens, D.D.S.

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1932226503
  NPD (past) Authorized official
• Josephine Maryetta Van Ess, DDS

  • General Practice Dentistry
  • Green Bay, WI
  • NPI 1700309978
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164549754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022639",
            "telephone_number": "920-468-6371",
            "fax_number": "920-468-6365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 MAIN ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543022639",
            "telephone_number": "920-468-6371",
            "fax_number": "920-468-6365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK GROVE DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREATENS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "920-468-6371",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly E O'Connor, CNM
• Maureen Patrice O'Connor, D.C.
• Wyatt O'Neil
• Margaret O'Toole, D.C
• Michael C O'Toole, MD
• Oak Grove Dental Associates, LLC
• OB-GYN Assoc of Green Bay LTD
• Elizabeth Oberndorfer
• Padraic Rory Obma, M.D.
• Kylene Elizabeth Occhietti, LICSW

• General Practice Dentistry in Green Bay, WI
• Providers in Green Bay, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.