Amber Jenkins Green, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012419 Issued in GA

Practice address

8200 Mall Pkwy Ste 155
Lithonia, GA 30038-6985

Phone

(770) 484-4051

NPI assigned

Oct 17, 2006

Last updated

Jul 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Amber Paulette Jenkins Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Beautiful Smiles Family Dentistry, DDS, PC

  • General Practice Dentistry
  • Lithonia, GA
  • NPI 1932280237
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1417038712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 MALL PKWY",
            "address_2": "SUITE #155",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386983",
            "telephone_number": "770-484-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 MALL PKWY STE 155",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300386985",
            "telephone_number": "770-484-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "AMBER",
        "middle_name": "JENKINS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000945843D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "JENKINS",
            "middle_name": "PAULETTE",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Charnise Greene, LMT
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• Ashley Griffith, PA
• Karen Griffiths, FNP-C

• General Practice Dentistry in Lithonia, GA
• Providers in Lithonia, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.