Courtney Ann Green, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

006800 Issued in CT

Practice address

15 Mercer Ave
East Hartford, CT 06118-1517

Phone

(860) 622-5514

Fax

(860) 622-5342

NPI assigned

Sep 3, 2008

Last updated

Nov 7, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Integrated Health Services, Inc.

  • Primary Care Clinic/Center
  • East Hartford, CT
  • NPI 1720250624
  NPD (past)

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1407004567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "869 FORBES ST",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181958",
            "telephone_number": "860-622-5340",
            "fax_number": "860-622-5342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 MERCER AVE",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181517",
            "telephone_number": "860-622-5514",
            "fax_number": "860-622-5342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "COURTNEY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "006800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "006800",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shrushti Gosar
• Grace Haven LLC
• Gianna Rae Grafton
• Kimberly Grant
• Sarah Grasso, CRNA
• Kristian Marie Greene
• Greensprings Healthcare and Rehabilitation Center LLC
• Greloch Eyecare, LLC
• Jennifer Greloch, OD
• Robert Michael Grillo, D.M.D.

• Dental Hygienist in East Hartford, CT
• Providers in East Hartford, CT by specialty
• Dental Hygienist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.