William Nettles Green, DMD MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

3214 Issued in SC

Practice address

3741 Landmark Drive
Columbia, SC 29204-4313

Phone

(803) 787-1601

Fax

(803) 787-0811

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. W Nettles Green Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689731143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3741 LANDMARK DRIVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044313",
            "telephone_number": "803-787-1601",
            "fax_number": "803-787-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 LANDMARK DRIVE",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292044313",
            "telephone_number": "803-787-1601",
            "fax_number": "803-787-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "WILLIAM",
        "middle_name": "NETTLES",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "SC",
            "license": "3214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "976521",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W",
            "last_name": "GREEN",
            "middle_name": "NETTLES",
            "prefix": "DR.",
            "credential": "DMD MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Richard Alan Green, RPH
• Santiana Green, RBT
• Stephanie Walrath Green
• Tieyanna Yaniqueka Green
• Timothy Francis Green
• Mary Alexandria Greenaway
• Stanley H Greenberg, M.D.
• Parker Greene-Kelly
• Alexandria Greene
• Amanda Greene

• Orthodontics and Dentofacial Orthopedics Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.