Brad Green, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3578 Issued in AR

Practice address

2421 N Center St Ste D
Fayetteville, AR 72701-9609

Phone

(479) 445-7281

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Brad H. Green D.D.S., P.a.

  • Dentist
  • Fayetteville, AR
  • NPI 1205175676
  NPD (past) Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682467200000",
    "number": "1083742928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293",
            "city": "ELKINS",
            "state": "AR",
            "postal_code": "727270293",
            "telephone_number": "479-445-6919",
            "fax_number": "479-445-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 N CENTER ST STE D",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727019609",
            "telephone_number": "479-445-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "BRAD",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Orthopedic Alliance of Therapists
• Breanna Michelle Greaves
• Abby Green
• Allison Marie Green, OTR/L
• Autumn Nicole Green
• Julie A Green, MA, CCC-SLP
• Michelle Marie Green, APRN
• Sarah Beth Green
• Tyler Green, PT,DPT
• Kylie Greening

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.