NPI 1487205233 · live from the CMS NPI Registry
J.R. Gregg LLC
Dentist, Orthodontics and Dentofacial Orthopedics in Gresham, OR. National Provider Identifier 1487205233, active.
NPI record
| NPI | 1487205233 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist, Orthodontics and Dentofacial Orthopedics 1223X0400X |
| Practice location | 1201 Se 223rd Ave Ste 220, Gresham, OR 97030 |
| Practice phone | 503-489-4546 |
| Mailing address | 1720 N. Old Bruceville Rd., Vincennes, IN 47591 |
| Enumerated | September 24, 2019 |
| Last updated | September 24, 2019 |
| Authorized official | Joseph Gregg, Orthodontist/Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist, Orthodontics and Dentofacial Orthopedics primary | 1223X0400X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.