Individual provider Active NPI

Maurice R. Growney, D.D.S.

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1508913419
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
790 Ulloa St
San Francisco, CA 94127-1115
Phone
(415) 566-8500
Fax
(415) 566-1437
NPI assigned
Jan 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X CA Primary

Addresses

Primary practice location

790 Ulloa St
San Francisco, CA 94127-1115

Mailing address

790 Ulloa St
San Francisco, CA 94127-1115
Phone (415) 566-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160623001440 CA Order and Referring Only - DentistPractitioner - Dentist 0244521110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
943346607CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508913419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 ULLOA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271115",
            "telephone_number": "415-566-8500",
            "fax_number": "415-566-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 ULLOA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271115",
            "telephone_number": "415-566-8500",
            "fax_number": "415-566-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROWNEY",
        "first_name": "MAURICE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.