Active NPI
Jonathan Edward Greene, DDS
- Dentist
- Norwich, CT
National Provider Identifier
1194735563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 009537
- Practice address
- 65 Sachem St
Norwich, CT 06360-4201 - Phone
- (860) 889-8427
- Fax
- (860) 204-9402
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 009537 | CT | Primary |
| General Practice Dentistry | 1223G0001X | DEN02733 | RI |
Addresses
Primary practice location
65 Sachem St
Norwich, CT 06360-4201
Mailing address
65 Sachem St
Norwich, CT 06360-4201
Phone (860) 889-8427
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 |
|---|---|---|---|
| DEN02733 | RI | MD | General Practice Dentistry |
| 009537 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greene Dental Group, LLC | 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.
-
- Dental Clinic/Center
- Norwich, CT
- NPI 1497952923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457913600000",
"number": "1194735563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 SACHEM ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604201",
"telephone_number": "860-889-8427",
"fax_number": "860-204-9402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 SACHEM ST",
"city": "NORWICH",
"state": "CT",
"postal_code": "063604201",
"telephone_number": "860-889-8427",
"fax_number": "860-204-9402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "JONATHAN",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2016-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "009537",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "RI",
"license": "DEN02733",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwich, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.