Individual provider Active NPI

Charles Edward Gregory, D.D.S.

  • Endodontics
  • Atlanta, GA
National Provider Identifier
1730461492
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7172 Issued in GA
Practice address
5555 Peachtree Dunwoody Rd NE
Suite 275
Atlanta, GA 30342-1703
Phone
(404) 256-4772
Fax
(404) 843-1743
NPI assigned
Sep 19, 2011
Last updated
Sep 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 7172 GA Primary

Addresses

Primary practice location

5555 Peachtree Dunwoody Rd NE
Suite 275
Atlanta, GA 30342-1703

Mailing address

5555 Peachtree Dunwoody Rd NE
Suite 275
Atlanta, GA 30342-1703
Phone (404) 256-4772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7172GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1730461492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-256-4772",
            "fax_number": "404-843-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 275",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-256-4772",
            "fax_number": "404-843-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "CHARLES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-19",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "GA",
            "license": "7172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.