Gary Thomas Gregg, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00005828 Issued in WA

Practice address

700 N Devine Rd
Vancouver, WA 98661-6964

Phone

(360) 750-1385

Fax

(360) 750-1798

NPI assigned

Nov 21, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326021650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 N DEVINE RD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616964",
            "telephone_number": "360-750-1385",
            "fax_number": "360-750-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N DEVINE RD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986616964",
            "telephone_number": "360-750-1385",
            "fax_number": "360-750-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGG",
        "first_name": "GARY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE IDENTIFIER",
            "identifier": "DELTA DENTAL",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA DENTAL LICENSE #",
            "identifier": "DE00005828",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "073914000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra Lynn Greenholtz-Carrillo, MS CCC SCP
• Jessica Ann Greenwell, CDPT
• April Greenwood
• Justin Michael Greenwood
• Barbara Joann Greer
• Katherine Tracy Gregg
• Jennifer Sinclair Gregor, MSPT
• Gregory D Strebel DO LLC
• Becca Gregory, LICSW
• Crystal Gregory

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• 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.

Verify at the official NPI Registry.