NPIMap

Organization Active NPI

The Greenawalt Dhaliwal LLP

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Prchard, WA
National Provider Identifier
1255082632
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
THE GREENAWALT DHALIWAL LLP
Practice address
450 S Kitsap Blvd.
Ste 220
Port Prchard, WA 98366
Phone
(360) 447-5100
NPI assigned
Jan 17, 2022
Organization subpart
Yes
Parent organization
THE GREENAWALT DHALIWAL LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paul Greenawalt, DDSNPI 1700948551
Title
Partner/Owner/Oral Surgeon
Phone
(360) 698-9335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X

Addresses

Primary practice location

450 S Kitsap Blvd.
Ste 220
Port Prchard, WA 98366

Mailing address

PO Box 3770
Silverdale, WA 98383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000372 WA Part B Supplier - Clinic/Group Practice 1759279995 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Poulsbo, WA; Silverdale, WA; Port Orchard, WA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Greenawalt Dhaliwal LLP3 organizations share this tax ID, including this one
Part of
The Greenawalt Dhaliwal LLP

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

450 S Kitsap Blvd
Ste 220
Port Orchard, WA 98366
Phone (360) 447-5100

19503 7th Ave NE
Ste 100
Poulsbo, WA 98370
Phone (360) 779-2339

19365 7th Ave NE
Poulsbo, WA 98370
Phone (360) 779-2339

2021 NW Myhre Pl
Ste 210
Silverdale, WA 98383
Phone (360) 698-9335

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1642377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1255082632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3770",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S KITSAP BLVD.",
            "address_2": "STE 220",
            "city": "PORT PRCHARD",
            "state": "WA",
            "postal_code": "98366",
            "telephone_number": "360-447-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GREENAWALT DHALIWAL LLP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE GREENAWALT DHALIWAL LLP",
        "enumeration_date": "2022-01-17",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "GREENAWALT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PARTNER/OWNER/ORAL SURGEON",
        "authorized_official_telephone_number": "360-698-9335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.