Individual provider Active NPI

Ashley M Greco, DMD

  • General Practice Dentistry
  • Greenwood, MS
National Provider Identifier
1962994814
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3994-18 Issued in MS
Practice address
910 Medallion Dr
Greenwood, MS 38930-2118
Phone
(662) 455-9149
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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 3994-18 MS Primary

Addresses

Primary practice location

910 Medallion Dr
Greenwood, MS 38930-2118

Mailing address

1313 W Highway 8
Cleveland, MS 38732-2240
Phone (662) 588-8257

Other practice location 1

1313 W Highway 8
Cleveland, MS 38732-2240
Phone (662) 843-8353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3994-18MSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Dental LLC Past Accepting new patients
Lifetime Dental PLLC General Practice PastSince Nov 27, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1962994814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 W HIGHWAY 8",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322240",
            "telephone_number": "662-588-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 MEDALLION DR",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302118",
            "telephone_number": "662-455-9149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1313 W Highway 8",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "MS",
            "postal_code": "387322240",
            "country_code": "US",
            "telephone_number": "662-843-8353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRECO",
        "first_name": "ASHLEY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3994-18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.