Thomas H. Greene DMD Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1596 Issued in WV

Legal business name

THOMAS H. GREENE DMD INC

Practice address

1109 Fledderjohn Rd
Charleston, WV 25314-4204

Phone

(304) 345-7402

Fax

(304) 345-7402

NPI assigned

Nov 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carole F Greene

Title

V. Pres-Busi. MGR.

Phone

(304) 345-7402

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447324884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 FLEDDERJOHN RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253144204",
            "telephone_number": "304-345-7402",
            "fax_number": "304-345-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 FLEDDERJOHN RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253144204",
            "telephone_number": "304-345-7402",
            "fax_number": "304-345-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS H. GREENE DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "V. PRES-BUSI. MGR.",
        "authorized_official_telephone_number": "304-345-7402",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "1596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135218000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "464482",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "545343",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Thetford Dorado, MA
• Brooke E Thibodaux
• Dina Kay Thistlethwaite, MA
• Ian Daniel Thistlethwaite
• Timothy Lawrence Thistlethwaite, M.D.
• Thomas Hunter & Associates, PLLC
• Amanda Thomas
• Amanda Thomas
• Amy Thomas
• Billie Jo Thomas

• General Practice Dentistry in Charleston, WV
• Providers in Charleston, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.