Active NPI
Keira Vale Greene, DDS
- Dentist
- Hayden, ID
National Provider Identifier
1164626883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-4879
- Practice address
- 8636 N Wayne Dr
Hayden, ID 83835-5084 - Phone
- (303) 810-9296
- NPI assigned
- Jun 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D-4879 | ID | Primary |
Addresses
Primary practice location
8636 N Wayne Dr
Hayden, ID 83835-5084
Mailing address
9323 N Government Way Ste 44
Hayden, ID 83835-8256
Phone (303) 810-9296
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D-4879 | Other | ID | DENTAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-4879 | ID | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Dental, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Tulsa, OK
- NPI 1700030657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601424000000",
"number": "1164626883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9323 N GOVERNMENT WAY STE 44",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838358256",
"telephone_number": "303-810-9296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8636 N WAYNE DR",
"city": "HAYDEN",
"state": "ID",
"postal_code": "838355084",
"telephone_number": "303-810-9296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "KEIRA",
"middle_name": "VALE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-14",
"last_updated": "2020-09-30",
"certification_date": "2020-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-4879",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "D-4879",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hayden, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.