Individual provider Active NPI

Gregory Jeneary, DDS

  • Dentist
  • Le Mars, IA
National Provider Identifier
1831397314
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08490 Issued in IA
Practice address
827 Holton Drive
Le Mars, IA 51031
Phone
(712) 546-4556
Fax
(712) 546-4568
NPI assigned
Jul 6, 2007
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 08490 IA Primary

Addresses

Primary practice location

827 Holton Drive
Le Mars, IA 51031

Mailing address

827 Holton Drive
Le Mars, IA 51031
Phone (712) 546-4556

Other identifiers 1

IdentifierTypeStateIssuer
08490OtherIAIOWA STATE DENTAL LICENSE

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
08490IAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeneary & Erdmann Integrative Dentistry LLP Past Accepting new patients
Thomas M Jeneary DDS PC PastSince Aug 2, 2020 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1831397314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 HOLTON DRIVE",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "51031",
            "telephone_number": "712-546-4556",
            "fax_number": "712-546-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 HOLTON DRIVE",
            "city": "LE MARS",
            "state": "IA",
            "postal_code": "51031",
            "telephone_number": "712-546-4556",
            "fax_number": "712-546-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENEARY",
        "first_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-06",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA STATE DENTAL LICENSE",
            "identifier": "08490",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Mars, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.