Larry Greenbaum, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4686 Issued in MD

Practice address

5480 Wisconsin Ave
4708 Bradley Blvd T2
Chevy Chase, MD 20815

Phone

(301) 652-6011

Fax

(301) 656-7433

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1508930306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE",
            "address_2": "SUITE 208",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "20815",
            "telephone_number": "301-652-6011",
            "fax_number": "301-656-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE",
            "address_2": "4708 BRADLEY BLVD T2",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "20815",
            "telephone_number": "301-652-6011",
            "fax_number": "301-656-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBAUM",
        "first_name": "LARRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "4686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND DENTAL LICENSE",
            "identifier": "4686",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Francis Grande, MD
• Whitney Julia Grandy, DPT
• Joseph Granger, DACM
• George W Graves, MD
• Vincent E Greco, DDS
• David Bruce Greenberg, DMD
• Mariam Gregorian, PH.D.
• Charlotte Grinberg, MD
• Judith Naomi Grobstein, AU.D.
• Rebecca M Gross, MD

• General Practice Dentistry in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.