NPIMap

Organization Active NPI

The Greenawalt Dhaliwal LLP

Doing business as Kitssap OMS

  • Oral and Maxillofacial Surgery (Dentist)
  • Silverdale, WA
National Provider Identifier
1881897999
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DE8080 Issued in WA
Legal business name
THE GREENAWALT DHALIWAL LLP
Doing business as
Kitssap OMS
Practice address
2021 NW Myhre Rd
#210
Silverdale, WA 98383
Phone
(360) 698-9335
Fax
(360) 698-9385
NPI assigned
Jun 6, 2007
Last updated
Feb 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Dr. Paul B Greenawalt, DDSNPI 1700948551
Title
Partner
Phone
(360) 698-9335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 8080 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6714 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6951 WA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE8080 WA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DE60016824 WA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X WA

Addresses

Primary practice location

2021 NW Myhre Rd
#210
Silverdale, WA 98383

Mailing address

P.O. Box 3770
Silverdale, WA 98383
Phone (360) 698-9335

Other identifiers 1

IdentifierTypeStateIssuer
115138700OtherWAMEDICARE ID #

Other names 1

  • Kitssap OMS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309000372 WA Part B Supplier - Clinic/Group Practice 1759279995 Receives reassigned benefits from 3 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Poulsbo, WA; Silverdale, WA; Port Orchard, WA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Greenawalt Dhaliwal LLP3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1881897999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 3770",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-698-9335",
            "fax_number": "360-698-9385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 NW MYHRE RD",
            "address_2": "#210",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "98383",
            "telephone_number": "360-698-9335",
            "fax_number": "360-698-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GREENAWALT DHALIWAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "GREENAWALT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-698-9335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "8080",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "6714",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "6951",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE8080",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE60016824",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "WA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID #",
            "identifier": "115138700",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kitssap OMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.