Individual provider Active NPI

Joseph Riley Patteson

  • Dentist
  • Greensboro, NC
National Provider Identifier
1609445741
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12305 Issued in NC
Practice address
200 E Wendover Ave Ste a
Greensboro, NC 27401-1227
Phone
(336) 275-4747
NPI assigned
Jun 23, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12305 NC Primary

Addresses

Primary practice location

200 E Wendover Ave Ste a
Greensboro, NC 27401-1227

Mailing address

4711 Groometown Rd
Greensboro, NC 27407-9605

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
I20250228002693 NC Practitioner - Dentist 1153842547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Erin Rake, DDS, P.C. Dentist CurrentSince Nov 30, 2024 Accepting new patients
Mango & Patteson PLLC Current Accepting new patients

Locations

8500 W 110th St
Ste 450
Overland Park, KS 66210
Phone (913) 362-1112

201 McCullough Dr
Ste 180
Charlotte, NC 28262
Phone (704) 228-8495

200 E Wendover Ave
Ste A
Greensboro, NC 27401
Phone (336) 275-4747

Organizations & group practices 2

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1609445741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4711 GROOMETOWN RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274079605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E WENDOVER AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011227",
            "telephone_number": "336-275-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTESON",
        "first_name": "JOSEPH",
        "middle_name": "RILEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.