Lacey Nicole Greenwald, DDS
Individual provider Active NPI General Practice Dentistry · Keokuk, IA
NPI 1619280807 · NPPES record last updated Jul 16, 2010
Key facts
- NPI
- 1619280807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 08720 (IA)
- Practice address
- 307 N 17TH St
Keokuk, IA 52632-3419 - Phone
- (319) 524-2728
- NPI assigned
- Jul 16, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 30, 2015 through Sep 30, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08720 | IA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gerald H. Schleier, D.D.S., S.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 08720 | IA | Yes |
Addresses
Primary practice location
307 N 17TH St
Keokuk, IA 52632-3419
Mailing address
307 N 17TH St
Keokuk, IA 52632-3419
Phone (319) 524-2728
Other providers in Keokuk, IA
- Kathrin Frankenhoff
- Gemini Travel & Shuttle
- Gerald H. Schleier, D.D.S., S.C.
- Kirk Dennis Green
- Ricky James Greenfield
- Lori Griswold
- Thomas E Hakes
- Erin Harbison
- Terry W Hargens
- Harper Family Health Clinic LLC
All providers in Keokuk, IA · General Practice Dentistry in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.