Jason Ted Geary, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D4234 Issued in ID

Practice address

3001 A 6TH St
Naval Health Clinic
Great Lakes, IL 60088

Phone

(847) 688-2100

NPI assigned

Jun 30, 2009

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1871721761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 A 6TH ST",
            "address_2": "NAVAL HEALTH CLINIC - ATTN CREDENTIALING DEPARTMENT",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 A 6TH ST",
            "address_2": "NAVAL HEALTH CLINIC",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "60088",
            "telephone_number": "847-688-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEARY",
        "first_name": "JASON",
        "middle_name": "TED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D4234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Fuchs
• John Allan Clayton Fulling, IDC
• Deborah Jeanne Galen, M.D.
• Walter Gallagher
• David Aaron Galvan, IDC
• Steven Leon Geary, DPM
• Jesse Robert Geibe, MD, MPH, MBA
• Gerald J. George, R.PH.
• Richard E Gerhardt, D.D.S.
• Saman Reza Gharib, DMD

• General Practice Dentistry in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.