Chad C Green, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

29328 Issued in TX

Practice address

1005 Long Prairie Rd Ste 100
Flower Mound, TX 75022-4232

Phone

(972) 538-3700

NPI assigned

Apr 23, 2013

Last updated

May 2, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1275977068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 LONG PRAIRIE RD STE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224232",
            "telephone_number": "972-538-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 LONG PRAIRIE RD STE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224232",
            "telephone_number": "972-538-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "CHAD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-23",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "29328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilliesha Grandberry
• Jane C. Gray, LPC
• Mary Catherine Gray, PT
• Melanie Gray, D.O.
• Green Hills Associates PLLC
• Destiny Green
• Marlo Greenfield
• Greenside 25 Incorporated (Compassionate Connections)
• Mackenzie Greer
• Olesya Bodyu Griffith, FNP-C

• Endodontics in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.