Individual provider Active NPI

Greggery E Jones, DMD

  • Dentist
  • Redmond, OR
National Provider Identifier
1295961860
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D5188 Issued in OR
Practice address
774 SW Rimrock Way
Redmond, OR 97756-1941
Phone
(541) 923-7633
NPI assigned
Jun 9, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D5188 OR Primary

Addresses

Primary practice location

774 SW Rimrock Way
Redmond, OR 97756-1941

Mailing address

54990 Mallard Dr
Bend, OR 97707-2409
Phone (541) 923-7633

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D5188ORMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1295961860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54990 MALLARD DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977072409",
            "telephone_number": "541-923-7633",
            "fax_number": "541-923-8733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 SW RIMROCK WAY",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561941",
            "telephone_number": "541-923-7633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "GREGGERY",
        "middle_name": "E",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-09",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D5188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.