Individual provider Active NPI

John C Greif, DDS, MSD

  • Periodontics
  • Evansville, IN
National Provider Identifier
1194749309
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
12008907 Issued in IN
Practice address
1212 Professional Blvd
Evansville, IN 47714-8002
Phone
(812) 477-6112
Fax
(812) 477-3510
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
Yes

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
Periodontics 1223P0300X 12008907 IN Primary

Addresses

Primary practice location

1212 Professional Blvd
Evansville, IN 47714-8002

Mailing address

1212 Professional Blvd
Evansville, IN 47714-8002
Phone (812) 477-6112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20151030001779 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103006606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12008907INMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
John C Greif DDS MSD LLC Periodontics CurrentSince Jul 9, 2023 Accepting new patients

Locations

1212 Professional Blvd
Evansville, IN 47714
Phone (812) 477-6112

Organizations & group practices 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194749309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148002",
            "telephone_number": "812-477-6112",
            "fax_number": "812-477-3510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148002",
            "telephone_number": "812-477-6112",
            "fax_number": "812-477-3510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREIF",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IN",
            "license": "12008907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.