Provider Demographics
NPI:1053642181
Name:STEVEN C. GREENMAN, D.D.S., INC.
Entity Type:Organization
Organization Name:STEVEN C. GREENMAN, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GREENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-496-9555
Mailing Address - Street 1:3056 THREE SPRINGS DR
Mailing Address - Street 2:SUITE 223
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5581
Mailing Address - Country:US
Mailing Address - Phone:805-496-9555
Mailing Address - Fax:805-497-2541
Practice Address - Street 1:1240 S WESTLAKE BLVD
Practice Address - Street 2:SUITE 223
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-1929
Practice Address - Country:US
Practice Address - Phone:805-496-9555
Practice Address - Fax:805-497-2541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-29
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29903261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6360970001Medicare NSC