Individual provider Active NPI

Saulo Geraldeli, DDS MS PHD

  • Periodontics
  • Greenville, NC
National Provider Identifier
1407950413
Registry record updated Sep 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
00211 Issued in NC
Practice address
1851 Macgregor Downs Rd
Greenville, NC 27834-5925
Phone
(252) 737-7067
Fax
(252) 737-7757
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 00211 NC Primary

Addresses

Primary practice location

1851 Macgregor Downs Rd
Greenville, NC 27834-5925

Mailing address

1851 Macgregor Downs Rd
Greenville, NC 27834-5925
Phone (252) 737-7067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190924000279 NC Practitioner - Dentist 9234438284 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00211NCMDPeriodontist
0211NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Current Accepting new patients
East Carolina University CurrentSince Jul 8, 2019 Accepting new patients
East Carolina University CurrentSince Jul 8, 2019 Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1407950413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 MACGREGOR DOWNS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345925",
            "telephone_number": "252-737-7067",
            "fax_number": "252-737-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 MACGREGOR DOWNS RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345925",
            "telephone_number": "252-737-7067",
            "fax_number": "252-737-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERALDELI",
        "first_name": "SAULO",
        "credential": "DDS MS PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NC",
            "license": "00211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.