NPIMap

Organization Active NPI

Green Dentistry PLLC

  • Dentist
  • Ogden, UT
National Provider Identifier
1366986705
Registry record updated Dec 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7692415-9922 Issued in UT
Legal business name
GREEN DENTISTRY PLLC
Practice address
707 24TH St
Ste 2a
Ogden, UT 84401-2580
Phone
(801) 648-3653
NPI assigned
Dec 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2016

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

Authorized official

Name
Dr. John Green, DMDNPI 1497065551
Title
Owner
Phone
(801) 648-3653

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
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 7692415-9922 UT Primary

Addresses

Primary practice location

707 24TH St
Ste 2a
Ogden, UT 84401-2580

Mailing address

5029 S 1200 E
Ogden, UT 84403-4297
Phone (801) 648-3653

National Provider Directory

National Provider Directory

Locations

707 24th St
Ste 2A
Ogden, UT 84401
Phone (801) 648-3653

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": "1480809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480809600000",
    "number": "1366986705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5029 S 1200 E",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034297",
            "telephone_number": "801-648-3653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 24TH ST",
            "address_2": "STE 2A",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844012580",
            "telephone_number": "801-648-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-04",
        "last_updated": "2016-12-04",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-648-3653",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "7692415-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2016; 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.