Individual provider Active NPI

Zachary Kyle Greene, DDM

  • General Practice Dentistry
  • Cranston, RI
National Provider Identifier
1083276224
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN03466 Issued in RI
Practice address
1090 Cranston St
Cranston, RI 02920-7323
Phone
(401) 942-4867
NPI assigned
Jul 8, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DEN03466 RI Primary

Addresses

Primary practice location

1090 Cranston St
Cranston, RI 02920-7323

Mailing address

311 Doric Ave
Cranston, RI 02910-2903
Phone (401) 467-9610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220705001160 AL Practitioner - Dentist 8527398726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN03466RIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Health Services Inc Single Specialty CurrentSince Jul 1, 2022 Accepting new patients

Locations

511 E Tuskeena St
Hayneville, AL 36040
Phone (334) 548-2516

2611 Woodley Park Dr
Montgomery, AL 36116
Phone (334) 288-0009

3058 Mobile Hwy
Montgomery, AL 36108
Phone (334) 293-6670

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1083276224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903",
            "telephone_number": "401-467-9610",
            "fax_number": "401-467-9030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 CRANSTON ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029207323",
            "telephone_number": "401-942-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "ZACHARY",
        "middle_name": "KYLE",
        "credential": "DDM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN03466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.