Stephen Charles Greer II DMD, D.M.D

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

3270-03 Issued in MS

Practice address

401 Baptist Drive, Suite 207
Madison, MS 39110

Phone

(706) 721-9744

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396051200000",
    "number": "1720202153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DRIVE, SUITE 207",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DRIVE, SUITE 207",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "39110",
            "telephone_number": "706-721-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREER II DMD",
        "first_name": "STEPHEN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2014-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MS",
            "license": "3270-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08250764",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Ross Goff, LPC
• Traci Goodwin, RD
• Breckin Skye Gray, FNP
• David Green, M.D.
• Michael Greene, DO
• Claire Dornbusch Griner, D.M.D.
• Heatherly Henson Grissom, D.M.D.
• Jason Scott Grissom, D.M.D.
• Lindsey Morgan Groce
• Mark Leslie Grogan

• Oral and Maxillofacial Surgery (Dentist) in Madison, MS
• Providers in Madison, MS by specialty
• Oral and Maxillofacial Surgery (Dentist) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2014; 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.