Greene Dental Management, PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

GREENE DENTAL MANAGEMENT, PLLC

Practice address

1021 S Ridgewood Ave
Daytona Beach, FL 32114-6151

Phone

(386) 304-2677

NPI assigned

Sep 24, 2024

Organization subpart

No

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

Authorized official

Name

Stephen GreeneNPI 1194113373

Title

Owner

Phone

(850) 251-1643

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Stephen Lamar Greene, D.D.S

  • Pediatric Dentistry
  • Daytona Beach, FL
  • NPI 1194113373
  NPD Authorized official

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746576000000",
    "number": "1306663059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 S RIDGEWOOD AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321146151",
            "telephone_number": "386-304-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 S RIDGEWOOD AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321146151",
            "telephone_number": "386-304-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE DENTAL MANAGEMENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-24",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-251-1643"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas J Green, MD
• Thomas Justin Green Jr., M.D.
• Walter Craig Green Jr.
• Catherine Margaret Greenblum, PHD, APRN, FNP-BC
• Jesse Seth Greenblum, M.D.
• Alexander Greene, M.D.
• John Elbert Greene, M.D.
• Stephen Lamar Greene, D.D.S
• Stacy Dawn Greenlaw, R.D.H.
• Kristina Lynne Greenway, M.S., CCC-SLP

• Pediatric Dentistry in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.