Active NPI
Tiffany Priscilla Green, D.M.D.
- Pediatric Dentistry
- Flowood, MS
National Provider Identifier
1770515389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- PEDO-399-06
- Practice address
- 101 Luckney Station Rd
Flowood, MS 39232-8402 - Phone
- (601) 992-8000
- Fax
- (601) 992-8262
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | PEDO-399-06 | MS | Primary |
| General Practice Dentistry | 1223G0001X | 3296-04 | MS |
Addresses
Primary practice location
101 Luckney Station Rd
Flowood, MS 39232-8402
Mailing address
101 Luckney Station Rd
Flowood, MS 39232-8402
Phone (601) 992-8000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3296-04 | MS | MD | General Practice Dentistry |
| PEDO-399-06 | MS | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1770515389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 LUCKNEY STATION RD",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392328402",
"telephone_number": "601-992-8000",
"fax_number": "601-992-8262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LUCKNEY STATION RD",
"city": "FLOWOOD",
"state": "MS",
"postal_code": "392328402",
"telephone_number": "601-992-8000",
"fax_number": "601-992-8262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "TIFFANY",
"middle_name": "PRISCILLA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MS",
"license": "PEDO-399-06",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MS",
"license": "3296-04",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flowood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.