Mark S. Greskovich, D.M.D, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN0011988 Issued in FL

Practice address

4850 N 9TH Ave Ste 4
Pensacola, FL 32503-2406

Phone

(850) 477-1125

Fax

(850) 479-5809

NPI assigned

Jul 8, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Mark S. Greskovich DMD PA

  • Oral and Maxillofacial Surgery (Dentist)
  • Pensacola, FL
  • NPI 1518281351
  NPD (past)
• James R. Deatherage D.M.D.,P.C.

  • Dentist
  • Brewton, AL
  • NPI 1730404187
  NPD (past)
• Michael a. Dasinger

  • General Practice Dentistry
  • Brewton, AL
  • NPI 1891959151
  NPD (past)

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1316970197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-477-1125",
            "fax_number": "850-479-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 N 9TH AVE STE 4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032406",
            "telephone_number": "850-477-1125",
            "fax_number": "850-479-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRESKOVICH",
        "first_name": "MARK",
        "middle_name": "S.",
        "credential": "D.M.D, PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN0011988",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "4229",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Louise Grencer-Liegel, NP
• Thomas Grenier, MD
• Lila Sue Greninger James, RN BSN
• Carla Greskovich, ARNP
• Frank John Greskovich III, M.D.
• Asahel L Gridley, MD
• Pamela Michelle Grier-Hall, MD
• Roy Dennis Griewisch
• Angelyn Columbia Griffin
• Daneshia Griffin, MSW

• Oral and Maxillofacial Surgery (Dentist) in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.

Verify at the official NPI Registry.