NPIMap

Organization Active NPI

Greene Dental Group, LLC

  • Dental Clinic/Center
  • Norwich, CT
National Provider Identifier
1497952923
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
009537 Issued in CT
Legal business name
GREENE DENTAL GROUP, LLC
Practice address
65 Sachem St
Norwich, CT 06360-4201
Phone
(860) 889-8427
Fax
(860) 204-9402
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Authorized official

Name
Dr. Jonathan Edward Greene, DDSNPI 1194735563
Title
President
Phone
(860) 889-8427

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
Dental Clinic/Center 261QD0000X 009537 CT Primary

Addresses

Primary practice location

65 Sachem St
Norwich, CT 06360-4201

Mailing address

65 Sachem St
Norwich, CT 06360-4201
Phone (860) 889-8427

National Provider Directory

National Provider Directory

Locations

65 Sachem St
Norwich, CT 06360
Phone (860) 889-8427

Practitioners & affiliated clinicians

Practitioners 4

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": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403222400000",
    "number": "1497952923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 SACHEM ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063604201",
            "telephone_number": "860-889-8427",
            "fax_number": "860-204-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 SACHEM ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063604201",
            "telephone_number": "860-889-8427",
            "fax_number": "860-204-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE DENTAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2014-06-20",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-889-8427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CT",
            "license": "009537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2014; 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.