Individual provider Active NPI

James Lee Greenwood Jr., D.D.S.

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1700947926
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15504 Issued in TX
Practice address
5925 Forest LN Ste 129
Dallas, TX 75230-2787
Phone
(972) 239-0914
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15504 TX Primary

Addresses

Primary practice location

5925 Forest LN Ste 129
Dallas, TX 75230-2787

Mailing address

5925 Forest LN Ste 129
Dallas, TX 75230-2787
Phone (972) 239-0914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160623000989 TX Order and Referring Only - DentistPractitioner - Dentist 2567753429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15504TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700947926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 129",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302787",
            "telephone_number": "972-239-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5925 FOREST LN STE 129",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302787",
            "telephone_number": "972-239-0914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWOOD",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.