Gregory R South, DMD PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

112 Harmon Lane
Suite a
Kernersville, NC 27284

Phone

(336) 993-3751

Fax

(336) 993-6601

NPI assigned

Oct 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

Other names 1

• Gregory R South Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811077142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HARMON LANE",
            "address_2": "SUITE A",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "27284",
            "telephone_number": "336-993-3751",
            "fax_number": "336-993-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HARMON LANE",
            "address_2": "SUITE A",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "27284",
            "telephone_number": "336-993-3751",
            "fax_number": "336-993-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTH",
        "first_name": "GREGORY",
        "middle_name": "R",
        "credential": "DMD PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "SOUTH",
            "middle_name": "R",
            "credential": "DMD PA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• General Practice Dentistry in Kernersville, NC
• Providers in Kernersville, NC by specialty
• General Practice Dentistry in North Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.