Active NPI
Brad H. Green D.D.S., P.a.
- Dentist
- Fayetteville, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3578
- Legal business name
- BRAD H. GREEN D.D.S., P.A.
- Practice address
- 2421 N Center St
Suite D
Fayetteville, AR 72701-9455 - Phone
- (479) 445-6919
- Fax
- (479) 445-6929
- NPI assigned
- Feb 5, 2013
- Last updated
- Feb 5, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Brad Green, D.D.S.
- Title
- Owner
- Phone
- (479) 445-7281
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3578 | AR | Primary |
Addresses
Primary practice location
2421 N Center St
Suite D
Fayetteville, AR 72701-9455
Mailing address
101 S Pittman St
Prairie Grove, AR 72753-3247
Phone (479) 846-1005
National Provider Directory
National Provider Directory- Tax ID family
- Brad H Green DDS PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Prairie Grove, AR
- NPI 1457548935
Locations
2421 N Center St
Ste D
Fayetteville, AR 72701
Phone (479) 445-6919
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Fayetteville, AR
- NPI 1083742928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360022400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1360022400000",
"number": "1205175676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S PITTMAN ST",
"city": "PRAIRIE GROVE",
"state": "AR",
"postal_code": "727533247",
"telephone_number": "479-846-1005",
"fax_number": "479-846-1014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2421 N CENTER ST",
"address_2": "SUITE D",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "727019455",
"telephone_number": "479-445-6919",
"fax_number": "479-445-6929"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRAD H. GREEN D.D.S., P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-05",
"last_updated": "2013-02-05",
"status": "A",
"authorized_official_last_name": "GREEN",
"authorized_official_first_name": "BRAD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "479-445-7281",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
- Carla Frances Boyd, RNP
- Katie Boydstun, LCSW
- Jeana Nicole Boyette, MHPP
- Amanda E Brackett, APN
- Brian Keith Bracy, M.D.
- Blaire Bradbury, LAC
- Erin Elizabeth Bradford, MS, OTR/L
- Makenzie Faith Bradford, OT
- Thomas Hal Bradford, MD
- Bradley R Crossfield DDS of Northwest Arkansas PLLC (Tooth Squad Pediatric Dentistry)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.