Organization Active NPI

Green Oral Surgery PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Saginaw, TX
National Provider Identifier
1356870950
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
32346 Issued in TX
Legal business name
GREEN ORAL SURGERY PLLC
Practice address
715 W Bailey Boswell Rd
Saginaw, TX 76179
Phone
(817) 237-7557
NPI assigned
Jun 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Authorized official

Name
Dr. Glenn Terrell Green, DMD
Title
Owner
Phone
(208) 406-1777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 32346 TX Primary

Addresses

Primary practice location

715 W Bailey Boswell Rd
Saginaw, TX 76179

Mailing address

715 W Bailey Boswell Rd
Saginaw, TX 76179-1279
Phone (817) 237-7557

National Provider Directory

National Provider Directory

Locations

715 W Bailey Boswell Rd
Saginaw, TX 76179
Phone (817) 237-7100

820 Towne Ct
Saginaw, TX 76179
Phone (817) 237-7557

Practitioners & affiliated clinicians

Practitioners 1

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": "1496793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709078400000",
    "number": "1356870950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W BAILEY BOSWELL RD",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761791279",
            "telephone_number": "817-237-7557",
            "fax_number": "817-237-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W BAILEY BOSWELL RD",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "76179",
            "telephone_number": "817-237-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN ORAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-07",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-26",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "TERRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-406-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "32346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.