NPIMap

Organization Active NPI

Robert O Greenwald DDS PC

  • Dentist
  • Bonne Terre, MO
National Provider Identifier
1962679746
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ROBERT O GREENWALD DDS PC
Practice address
#20 W Johnson
Bonne Terre, MO 63628
Phone
(573) 358-7566
Fax
(573) 358-1736
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Mrs. Rhonda Lyn Boyer
Title
Office Manager
Phone
(573) 358-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

#20 W Johnson
Bonne Terre, MO 63628

Mailing address

PO Box 149
#20 W Johnson
Bonne Terre, MO 63628
Phone (573) 358-7566

National Provider Directory

National Provider Directory

Locations

20 W Johnson St
Bonne Terre, MO 63628
Phone (573) 358-7561

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1962679746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 149",
            "address_2": "#20 W JOHNSON",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "63628",
            "telephone_number": "573-358-7566",
            "fax_number": "573-358-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#20 W JOHNSON",
            "city": "BONNE TERRE",
            "state": "MO",
            "postal_code": "63628",
            "telephone_number": "573-358-7566",
            "fax_number": "573-358-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT O GREENWALD DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "573-358-7566",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonne Terre, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.