Derek Green, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009748 Issued in AZ

Practice address

8535 E Hartford Dr Ste 202
Scottsdale, AZ 85255-5444

Phone

(480) 515-1000

NPI assigned

May 31, 2017

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

Locations

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.

• Derek Green DMD LLC

  • General Practice Dentistry
  • Anchorage, AK
  • NPI 1578130175
  NPD Authorized official
• Lachot PLLC

  • General Practice Dentistry
  • Scottsdale, AZ
  • NPI 1598585754
  NPD
• TR Rick Lawson DDS PC

  • Dentist
  • Scottsdale, AZ
  • NPI 1568719722
  NPD (past)

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1164950457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8535 E HARTFORD DR STE 202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555444",
            "telephone_number": "480-515-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8535 E HARTFORD DR STE 202",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852555444",
            "telephone_number": "480-515-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Green Lustig, ND
• Green Sage LLC
• Anthony Laine Green, M.D.
• Barry Green, MD
• Danielle Bianca Green, MD
• Destiny Green
• Emily Green, COTA/L
• Heidi Green, PSY.D.
• John R. Green, M.D.
• Shea Elizabeth Green, PA

• General Practice Dentistry in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.