Provider Demographics
NPI:1770458069
Name:GREGORY S MEYERS DDS MSD
Entity type:Organization
Organization Name:GREGORY S MEYERS DDS MSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:CPB, CPC, COC
Authorized Official - Phone:425-280-1542
Mailing Address - Street 1:1420 TARA HILLS DR STE C
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2530
Mailing Address - Country:US
Mailing Address - Phone:510-724-8441
Mailing Address - Fax:510-724-0120
Practice Address - Street 1:1420 TARA HILLS DR STE C
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2530
Practice Address - Country:US
Practice Address - Phone:510-724-8441
Practice Address - Fax:510-724-0120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty