Zachery K Green, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

#1151 Issued in WY

Practice address

125 County Road 250
Durango, CO 81301-8530

Phone

(970) 247-0682

NPI assigned

Jan 30, 2007

Last updated

Sep 30, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Twin Buttes Dental

  • Dentist
  • Durango, CO
  • NPI 1235591421
  NPD (past)
• Beatus Dentium, LLC

  dba Denteffex

  • Dental Clinic/Center
  • Cheyenne, WY
  • NPI 1477092781
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1003953316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COUNTY ROAD 250",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018530",
            "telephone_number": "970-247-0682",
            "fax_number": "970-247-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COUNTY ROAD 250",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813018530",
            "telephone_number": "970-247-0682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ZACHERY",
        "middle_name": "K",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "1511",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "#1151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124331400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Dawn Graves, LMT
• Rachel Graves, BA
• Tara Gray, PHD
• Susan Grayson, M.D.
• Katie Green, ATC
• Anne Marie Greenberg, LCSW
• David M Greenberg
• Greene Chiropractic, P.C.
• Kaitlyn Virginia Grieb, OTR/L
• Benjamin Griffin, PTA

• General Practice Dentistry in Durango, CO
• Providers in Durango, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.