Charles S Greene, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

190-12322 Issued in IL

Practice address

811 W Wellington Ave
Dept of Dentistry - Aimmc
Chicago, IL 60657-5123

Phone

(773) 871-4964

NPI assigned

Aug 20, 2006

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

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243382400000",
    "number": "1720193949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 RIDGE RD",
            "address_2": "APT. 304",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911560",
            "telephone_number": "847-256-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W WELLINGTON AVE",
            "address_2": "DEPT OF DENTISTRY - AIMMC",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575123",
            "telephone_number": "773-871-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "CHARLES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2009-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "190-12322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perrin Greene Jr, DSW
• Ann M Greene, PT
• Arielle Greene, MSW/LCSW
• Brecklyn Greene
• Cassandra Lynn Greene, APRN, CNP
• Christine D Greene
• Gideon Greene, LCPC
• Gretchen Thompson Greene
• Jaime Greene, DPT
• Kerrie Greene, MD, PHD

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.