Mark Adrian Grecco, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

34614 Issued in CA

Practice address

1511 West Yosemite Ave.
Manteca, CA 95337

Phone

(209) 824-7230

NPI assigned

Oct 25, 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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649355173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 WEST YOSEMITE AVE.",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "95337",
            "telephone_number": "209-824-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 WEST YOSEMITE AVE.",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "95337",
            "telephone_number": "209-824-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECCO",
        "first_name": "MARK",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "34614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paulette M. Gori, MD
• Carol Lynn Gray, LMFT
• Greater Modesto Medical Surgical Associates, Inc.
• Greater Modesto Medical Surgical Associates, Inc.
• Elizabeth C. Grecco, DDS
• Gurleen Grewal
• Tarundeep Singh Grewal, MD
• Nilda Santiago Grimes, LMFT
• Yazmin Guerra
• Alexander Guerrero, RN

• Oral and Maxillofacial Surgery (Dentist) in Manteca, CA
• Providers in Manteca, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.