Active NPI
Stuart D. Greenberg
- Orthodontics and Dentofacial Orthopedics Dentistry
- Roseville, CA
National Provider Identifier
1215902853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 35110
- Practice address
- 2428 Professional Dr
Roseville, CA 95661-7774 - Phone
- (916) 782-6073
- NPI assigned
- Feb 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 35110 | CA | Primary |
Addresses
Primary practice location
2428 Professional Dr
Roseville, CA 95661-7774
Mailing address
2428 Professional Dr
Roseville, CA 95661-7774
Phone (916) 782-6073
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35110 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215902853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2428 PROFESSIONAL DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956617774",
"telephone_number": "916-782-6073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2428 PROFESSIONAL DR",
"city": "ROSEVILLE",
"state": "CA",
"postal_code": "956617774",
"telephone_number": "916-782-6073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "STUART",
"middle_name": "D.",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "35110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, CA
Sources for this page
- 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.