Active NPI
Gregory Nielsen
- General Practice Dentistry
- North Billerica, MA
National Provider Identifier
1629606181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN1859444
- Practice address
- 315 Boston Rd
North Billerica, MA 01862-2635 - Phone
- (978) 391-6783
- NPI assigned
- Mar 31, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | DN1859444 | MA | Primary |
| Dentist | 122300000X | DN1859444 | MA |
Addresses
Primary practice location
315 Boston Rd
North Billerica, MA 01862-2635
Mailing address
1215 Lee St # 800740
Charlottesville, VA 22908-0816
Phone (434) 924-1774
Other practice location 1
1215 Lee St # 800740
Charlottesville, VA 22908-0816
Phone (434) 924-1774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200811000893 | VA | Order and Referring Only - Dentist | 2163847930 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1859444 | MA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665014400000",
"number": "1629606181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 LEE ST # 800740",
"city": "CHARLOTTESVILLE",
"state": "VA",
"postal_code": "229080816",
"telephone_number": "434-924-1774",
"fax_number": "434-243-6378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 BOSTON RD",
"city": "NORTH BILLERICA",
"state": "MA",
"postal_code": "018622635",
"telephone_number": "978-391-6783"
}
],
"practiceLocations": [
{
"address_1": "1215 Lee St # 800740",
"address_purpose": "LOCATION",
"city": "Charlottesville",
"state": "VA",
"postal_code": "229080816",
"country_code": "US",
"telephone_number": "434-924-1774",
"fax_number": "434-243-6378",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NIELSEN",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-31",
"last_updated": "2022-10-06",
"certification_date": "2022-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MA",
"license": "DN1859444",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859444",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Billerica, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.