Individual provider Active NPI

Gregory Earl Cheshire, D.M.D.

  • General Practice Dentistry
  • Melbourne, FL
National Provider Identifier
1952303059
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN0014021 Issued in FL
Practice address
2120 Sarno Rd
Melbourne, FL 32935-3084
Phone
(321) 241-6800
Fax
(321) 241-6888
NPI assigned
Jun 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN0014021 FL Primary

Addresses

Primary practice location

2120 Sarno Rd
Melbourne, FL 32935-3084

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other identifiers 1

IdentifierTypeStateIssuer
016523700MedicaidFL

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160721000423 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1355634866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0014021FLMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: gregory.cheshire@bha.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1952303059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1137",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329021137",
            "telephone_number": "321-952-9696",
            "fax_number": "321-952-7937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 SARNO RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329353084",
            "telephone_number": "321-241-6800",
            "fax_number": "321-241-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESHIRE",
        "first_name": "GREGORY",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0014021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016523700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.