Randolph Greene III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417510 Issued in VA

Practice address

303 S Colorado St
Salem, VA 24153-4948

Phone

(540) 300-6376

NPI assigned

Jun 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1497325583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S COLORADO ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241534948",
            "telephone_number": "540-300-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S COLORADO ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241534948",
            "telephone_number": "540-300-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "RANDOLPH",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417510",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "-0401417510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyndal Grammer, PH.D.
• Charles Dean Grant, M.D.
• Shonda Graybill
• Andrew Murray Greene, RN
• Nelson Greene, MD
• Stephen Lance Greer, CRNA
• Gregory T. Harvey DMD
• Will Dickson Griffeth, MD
• Edward Alan Griffin, MD
• Gary Lee Griffith, R.PH.

• General Practice Dentistry in Salem, VA
• Providers in Salem, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.