Samuel D Greenlee, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS-019921-L Issued in PA

Practice address

560 Van Reed Rd
Suite 202
Wyomissing, PA 19610-1799

Phone

(610) 374-8009

Fax

(610) 374-5552

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Penn'S Commons Dental Group

  • General Practice Dentistry
  • Wyomissing, PA
  • NPI 1801947775
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295886158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 VAN REED RD",
            "address_2": "SUITE 202",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101799",
            "telephone_number": "610-374-8009",
            "fax_number": "610-374-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 VAN REED RD",
            "address_2": "SUITE 202",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101799",
            "telephone_number": "610-374-8009",
            "fax_number": "610-374-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENLEE",
        "first_name": "SAMUEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS-019921-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna Ruth Graves, PT
• Gabrielle G Gravitt
• Erin Gray
• Macy Gray
• Greater Reading Mental Health Alliance
• Darryl Marsden Greenwood, O.D.
• Nicole Beth Greiss, LMT
• Hannah Gresh
• Salih Nigel Grevious, M.D.
• Marcia Grieder, CRNA

• General Practice Dentistry in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• General Practice Dentistry in Pennsylvania

• 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.
• 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.