NPIMap

Organization Active NPI

Greene Dental Associates

  • General Practice Dentistry
  • Beavercreek, OH
National Provider Identifier
1578717484
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30022493 Issued in OH
Legal business name
GREENE DENTAL ASSOCIATES
Practice address
3989 Colonel Glenn Hwy Ste a
Beavercreek, OH 45324-2099
Phone
(937) 426-2400
Fax
(937) 426-1144
NPI assigned
Nov 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Authorized official

Name
Dr. Percy Leslie Torkornoo, DDSNPI 1528133386
Title
President
Phone
(937) 626-2629

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 30022493 OH Primary

Addresses

Primary practice location

3989 Colonel Glenn Hwy Ste a
Beavercreek, OH 45324-2099

Mailing address

3989 Colonel Glenn Hwy Ste a
Beavercreek, OH 45324-2099
Phone (937) 426-2400

National Provider Directory

National Provider Directory

Locations

3989 Colonel Glenn Hwy
Ste A
Beavercreek, OH 45324
Phone (937) 426-2400

Practitioners & affiliated clinicians

Practitioners 1

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": "1225929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1578717484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3989 COLONEL GLENN HWY STE A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242099",
            "telephone_number": "937-426-2400",
            "fax_number": "937-426-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3989 COLONEL GLENN HWY STE A",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "453242099",
            "telephone_number": "937-426-2400",
            "fax_number": "937-426-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-06",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "TORKORNOO",
        "authorized_official_first_name": "PERCY",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-626-2629",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.