Provider Demographics
NPI:1902198294
Name:WINTER, GREGORY DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DAVID
Last Name:WINTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF ANESTHESIOLOGY STONY BROOK MEDICINE
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8480
Mailing Address - Country:US
Mailing Address - Phone:631-444-2975
Mailing Address - Fax:631-444-2907
Practice Address - Street 1:10203 TANAGER LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3943
Practice Address - Country:US
Practice Address - Phone:410-730-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14958122300000X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist
No122300000XDental ProvidersDentist