1659572972 NPI number — R. KEVIN GREENWAY, D.D.S. RALPH N. GREENWAY, D.D.S., P.C.

Table of content: (NPI 1659572972)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659572972 NPI number — R. KEVIN GREENWAY, D.D.S. RALPH N. GREENWAY, D.D.S., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
R. KEVIN GREENWAY, D.D.S. RALPH N. GREENWAY, D.D.S., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659572972
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 368
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VINTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24179-0368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-342-2949
Provider Business Mailing Address Fax Number:
540-345-3919

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
614 EAST WASHINGTON AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VINTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-342-2949
Provider Business Practice Location Address Fax Number:
540-345-3919
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GREENWAY
Authorized Official First Name:
R.
Authorized Official Middle Name:
KEVIN
Authorized Official Title or Position:
DENTIST
Authorized Official Telephone Number:
540-342-2949

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  0401007925 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com