NPIMap

Organization Active NPI

Anthony T.R. Green D.D.S.P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Jamaica, NY
National Provider Identifier
1235392283
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
ANTHONY T.R. GREEN D.D.S.P.C.
Practice address
17836 Wexford Ter
Suite 2E
Jamaica, NY 11432-3024
Phone
(718) 739-1300
Fax
(718) 739-0966
NPI assigned
Jul 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Anthony T.R. Green, D.D.S.O.M.F.S.NPI 1972584969
Title
Oral Surgeon/Owner
Phone
(718) 739-1300

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)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

17836 Wexford Ter
Suite 2E
Jamaica, NY 11432-3024

Mailing address

17836 Wexford Ter
Suite 2E
Jamaica, NY 11432-3024
Phone (718) 739-1300

Other identifiers 1

IdentifierTypeStateIssuer
02166558MedicaidNY

Other names 1

  • Anthony Green D.D.S. Other name

National Provider Directory

National Provider Directory

Locations

17836 Wexford Ter
Apt 2E
Jamaica, NY 11432
Phone (718) 739-1300

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1235392283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17836 WEXFORD TER",
            "address_2": "SUITE 2E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323024",
            "telephone_number": "718-739-1300",
            "fax_number": "718-739-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17836 WEXFORD TER",
            "address_2": "SUITE 2E",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323024",
            "telephone_number": "718-739-1300",
            "fax_number": "718-739-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY T.R. GREEN D.D.S.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "T.R.",
        "authorized_official_title_or_position": "ORAL SURGEON/OWNER",
        "authorized_official_telephone_number": "718-739-1300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S.O.M.F.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02166558",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anthony Green D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.