NPIMap

Organization Active NPI

Greenville Rancheria

  • Dental Clinic/Center
  • Quincy, CA
National Provider Identifier
1477345577
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GREENVILLE RANCHERIA
Practice address
78 E Central Ave
Quincy, CA 95971-9779
Phone
(530) 283-0980
NPI assigned
May 22, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Antonia Louise Hayworth
Title
Billing Supervisor
Phone
(530) 528-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

78 E Central Ave
Quincy, CA 95971-9779

Mailing address

1425 Montgomery Rd
Red Bluff, CA 96080-4605
Phone (530) 528-3481

National Provider Directory

National Provider Directory
Tax ID family
Greenville Rancheria Tribal6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

78 E Central Ave
Quincy, CA 95971
Phone (530) 283-0980

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1477345577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 MONTGOMERY RD",
            "city": "RED BLUFF",
            "state": "CA",
            "postal_code": "960804605",
            "telephone_number": "530-528-3481",
            "fax_number": "530-528-8612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 E CENTRAL AVE",
            "city": "QUINCY",
            "state": "CA",
            "postal_code": "959719779",
            "telephone_number": "530-283-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE RANCHERIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "HAYWORTH",
        "authorized_official_first_name": "ANTONIA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "530-528-8600"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.