Jesse N Greaves, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

277806 Issued in UT

Practice address

1401 E 3900 S
Suite 102
Salt Lake City, UT 84124-1475

Phone

(801) 272-8051

Fax

(801) 272-9109

NPI assigned

Aug 17, 2006

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

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Abundant Dental Care, P.C.

  • Public Health Dentistry
  • Holladay, UT
  • NPI 1063052256
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174636518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 3900 S",
            "address_2": "SUITE 102",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241475",
            "telephone_number": "801-272-8051",
            "fax_number": "801-272-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 3900 S",
            "address_2": "SUITE 102",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241475",
            "telephone_number": "801-272-8051",
            "fax_number": "801-272-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREAVES",
        "first_name": "JESSE",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "277806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "870570767HR1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KS PROVIDER",
            "identifier": "0000838204",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA PROVIDER",
            "identifier": "314279",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "1320390",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP PROVIDER",
            "identifier": "46060",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Graziosa, D.C., B.S.
• Diana Grazulis, MD
• Great Basin Chiropractic P.C.
• Greater Endodontics LLC
• Frank E Greaves Sr., LSA
• Talon Greeff, L.P.C.
• Green Chiropractic Center, Inc
• Green Chiropractic Clinic PC
• Green Sage Counseling
• Sophia Green-Baskett, CPHT

• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.