Nikki P Green, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21460 Issued in TX

Practice address

2512 Horne St
Ste. C
Fort Worth, TX 76107-4651

Phone

(817) 737-6601

Fax

(817) 737-6446

NPI assigned

May 7, 2007

Last updated

Dec 26, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• J. Walton Lawrence, Jr., D.D.S., Inc.

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1003998170
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1023221322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 HORNE ST",
            "address_2": "STE. C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761074651",
            "telephone_number": "817-737-6601",
            "fax_number": "817-737-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 HORNE ST",
            "address_2": "STE. C",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761074651",
            "telephone_number": "817-737-6601",
            "fax_number": "817-737-6446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "NIKKI",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "21460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani Monique Green
• John Green, RNFA
• Kydrianna M Green
• Michael Lewis Green Jr., M.D.
• Mistyanne Green
• Shamir Green
• Shantel Green
• Thom L Green, RPH
• Tiffany Green, M.ED, NCC, LPC
• Tina J Green, SLP

• General Practice Dentistry in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.