Mack Edward Greder II, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6038 Issued in NE

Practice address

7802 Davenport St
Omaha, NE 68114-3629

Phone

(402) 281-4238

Fax

(402) 315-9687

NPI assigned

Jan 25, 2007

Last updated

May 23, 2024By the provider in NPPES

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 NE

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

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1881740728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7802 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143629",
            "telephone_number": "402-281-4238",
            "fax_number": "402-315-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7802 DAVENPORT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143629",
            "telephone_number": "402-281-4238",
            "fax_number": "402-315-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREDER",
        "first_name": "MACK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-05-23",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "6038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greco PT & Armcare LLC (Greco PT & Armcare)
• Christine Susan Greco-Dawson
• Chaeli Greco, PT, DPT, OCS
• Mariah Greco
• Jennifer Anne Greder, D.D.S.
• Scott L Greder, O.D.
• Green Chiropractic Corrections
• Andrea Green Hines, M.D.
• Zanetar R Green-Graham
• Aaliyah Green

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.