Green Dental Studio

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105403 Issued in CO

Legal business name

GREEN DENTAL STUDIO

Practice address

6851 S Holly Cir Ste 250
Centennial, CO 80112-1050

Phone

(303) 770-3333

NPI assigned

May 23, 2007

Last updated

Aug 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Richard E Green, D.D.S., M.P.H.NPI 1063622629

Title

Owner

Phone

(303) 770-3333

Specialties & licenses 1

Addresses

Other names 1

• County Line Family Dental Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard Edward Green, D.D.S.

  • Dentist
  • Centennial, CO
  • NPI 1063622629
  NPD (past) Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1053521211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6851 S HOLLY CIR STE 250",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121050",
            "telephone_number": "303-770-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6851 S HOLLY CIR STE 250",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121050",
            "telephone_number": "303-770-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DENTAL STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-770-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.P.H."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "County Line Family Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Breanna R Graves, LPC
• Chloe Seline Graves, PT, DPT
• Jessica Gray
• Patrick Landon Gray, BCBA
• Shayla Gray
• Allison R Green, FNP-BC
• Brandon Green, PHARMD
• Freddrick Green
• Hailey Green
• Judy G Green, LCSW

• General Practice Dentistry in Centennial, CO
• Providers in Centennial, 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 Aug 7, 2013; 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.