Individual provider Active NPI

Heather Culleen Green-Morrison, D.D.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Shawnee, KS
National Provider Identifier
1659648541
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
61059 Issued in KS
Practice address
12125 Shawnee Mission Pkwy
Shawnee, KS 66216-1829
Phone
(913) 469-9191
NPI assigned
Nov 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 61059 KS Primary
Dentist 122300000X 054801 NY
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2014034197 MO

Addresses

Primary practice location

12125 Shawnee Mission Pkwy
Shawnee, KS 66216-1829

Mailing address

12810 W 119TH Ter
Overland Park, KS 66213-2374
Phone (312) 493-4613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
054801NYMDDentist
61059KSMDOrthodontics and Dentofacial Orthopedic Dentist
2014034197MOMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeremy R. Fry, D.D.S., M.S., LLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Dr. Robert W. Fry, D.D.S., M.S., P.a. Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1659648541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12810 W 119TH TER",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662132374",
            "telephone_number": "312-493-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12125 SHAWNEE MISSION PKWY",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161829",
            "telephone_number": "913-469-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN-MORRISON",
        "first_name": "HEATHER",
        "middle_name": "CULLEEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KS",
            "license": "61059",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054801",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MO",
            "license": "2014034197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.