Individual provider Active NPI

Stephen Daniel Greiner

  • Dentist
  • Mason, OH
National Provider Identifier
1407193626
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.023861 Issued in OH
Practice address
5112 Cedar Village Dr
Mason, OH 45040-3717
Phone
(513) 204-0054
NPI assigned
Jan 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.023861 OH Primary

Addresses

Primary practice location

5112 Cedar Village Dr
Mason, OH 45040-3717

Mailing address

5112 Cedar Village Dr
Mason, OH 45040-3717
Phone (513) 204-0054

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20161102002531 OH Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8820376437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.023861OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1407193626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5112 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403717",
            "telephone_number": "513-204-0054",
            "fax_number": "513-204-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5112 CEDAR VILLAGE DR",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450403717",
            "telephone_number": "513-204-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREINER",
        "first_name": "STEPHEN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-08",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.023861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.