Gregory Albert Royack, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00009399 Issued in WA

Practice address

616 Sixth Street
Bremerton, WA 98337

Phone

(360) 478-2368

Fax

(360) 475-3700

NPI assigned

Apr 17, 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 WA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740244623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98337",
            "telephone_number": "360-478-2366",
            "fax_number": "360-373-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 SIXTH STREET",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "98337",
            "telephone_number": "360-478-2368",
            "fax_number": "360-475-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYACK",
        "first_name": "GREGORY",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00009399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donette Lyn Rotta, LMHC
• Eren Roubal, PH.D.
• Tara Rought
• Trudy Ann Roush, PT
• Glen Warren Rovig, MA, CCC-A
• Amanda Lee Royer, BCBA
• Mitchell T Royster
• Marina Elizabeth Rozey
• James Jon Ruane, IDC
• Benjamin Rubio

• Dentist in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Dentist in Washington

• 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.