Audrey Greaves, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2017029554 Issued in MO

Practice address

1670 Beam Ave
Saint Paul, MN 55109-1201

Phone

(651) 925-8400

NPI assigned

Jul 22, 2014

Sex

Female

Sole proprietor

No

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

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1417364472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8970 WINDSOR TER",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554433800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 BEAM AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551091201",
            "telephone_number": "651-925-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREAVES",
        "first_name": "AUDREY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-22",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13455",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2017029554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great River Charter School
• Great River Dental P.a.
• Great River Psychotherapy PLLC
• Greater Minnesota Home Health Care Inc
• Greatmoore Home Care Agency LLC
• Neil Allen Greco, LICSW
• Green & White Mobility Corp.
• Green Transportation Services
• Alice Green, RD
• Mary Kathryn Green

• Dentist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.