Greg A Loitz, MD DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

G52694 Issued in CA

Practice address

33 Palma Ave
La Selva Beach, CA 95076-1729

Phone

(831) 566-1112

Fax

(833) 233-3943

NPI assigned

Nov 2, 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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1194803247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 PALMA AVE",
            "city": "LA SELVA BEACH",
            "state": "CA",
            "postal_code": "950761729",
            "telephone_number": "831-566-1112",
            "fax_number": "833-233-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 PALMA AVE",
            "city": "LA SELVA BEACH",
            "state": "CA",
            "postal_code": "950761729",
            "telephone_number": "831-566-1112",
            "fax_number": "833-233-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOITZ",
        "first_name": "GREG",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "G52694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL BOARD OF CALIF",
            "identifier": "G52694",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "833-233-3943",
            "affiliation": "N",
            "endpointDescription": "fax",
            "address_1": "33 Palma Ave",
            "city": "LA Selva Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950761729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Celina C Hernandez
• Homan Honarvar
• Sarai Jimenez
• Laura Lynn Jotzat
• Erica Kaczmar
• Katherine Angelina Loomis
• Jesus A Madrigal
• Brandon L Marquis
• Janet J Martin
• William A Martin, M.D.

• Oral & Maxillofacial Surgery (D.M.D.) in La Selva Beach, CA
• Providers in La Selva Beach, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.