Individual provider Active NPI

Greg R Novotny, D.D.S.

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1194933473
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22407 Issued in OH
Practice address
1084 S High St
Columbus, OH 43206-3409
Phone
(614) 444-0417
Fax
(614) 444-1091
NPI assigned
May 18, 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 22407 OH Primary

Addresses

Primary practice location

1084 S High St
Columbus, OH 43206-3409

Mailing address

1084 S High St
Columbus, OH 43206-3409
Phone (614) 444-0417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180111002903 PA Order and Referring Only - DentistPractitioner - Dentist 1557620846

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22407OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
German Village Dental Group, Nicole K. Munz, DDS, Inc. PastSince Mar 17, 2024 Accepting new patients
German Village Dental Group, L.L.C. 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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194933473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432063409",
            "telephone_number": "614-444-0417",
            "fax_number": "614-444-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432063409",
            "telephone_number": "614-444-0417",
            "fax_number": "614-444-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVOTNY",
        "first_name": "GREG",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "22407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.