Gregory Jon Anthony Prins, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4839 Issued in ID

Practice address

1305 Highway 2 West
Sandpoint, ID 83864

Phone

(208) 263-6806

NPI assigned

Jun 19, 2017

Last updated

Jul 21, 2022By the provider in NPPES

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 ID

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

State licenses

Interoperability endpoints

• Direct secure messaging: gregory.prins.p1@direct.kch.nextgenshare.com

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1760912042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 HIGHWAY 2",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "838642731",
            "telephone_number": "208-263-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 HIGHWAY 2 WEST",
            "city": "SANDPOINT",
            "state": "ID",
            "postal_code": "83864",
            "telephone_number": "208-263-6806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30410 Highway 200",
            "address_purpose": "LOCATION",
            "city": "Ponderay",
            "state": "ID",
            "postal_code": "838529601",
            "country_code": "US",
            "telephone_number": "208-263-7101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINS",
        "first_name": "GREGORY",
        "middle_name": "JON ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Poupart
• Robert Monroe Poutre, PA-C
• Julie A Price, MPT
• Mauria Prince, RPH
• Amber Dawn Prins, OD
• Providence Health & Services (Providence Spokane Heart Institute-Sandpoint)
• Psychological Consultants, PC
• Steven C Puffer, M.D.
• Jeffrey Pufnock, L.AC.
• Susan Mary Quinn Hurst, OTR/L, BCP

• General Practice Dentistry in Sandpoint, ID
• Providers in Sandpoint, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.