Active NPI
Ira M Greene, D.D.S.
- Pediatric Dentistry
- Avon, CT
National Provider Identifier
1801887633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5835CT
- Practice address
- 34 Dale Rd
Avon, CT 06001-3659 - Phone
- (330) 674-0874
- Fax
- (860) 674-8716
- NPI assigned
- Nov 1, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5835CT | CT | Primary |
Addresses
Primary practice location
34 Dale Rd
Avon, CT 06001-3659
Mailing address
10 Sachems TRL
West Simsbury, CT 06092-2525
Phone (860) 651-8428
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 |
|---|---|---|---|
| 5835CT | CT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1801887633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 SACHEMS TRL",
"city": "WEST SIMSBURY",
"state": "CT",
"postal_code": "060922525",
"telephone_number": "860-651-8428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 DALE RD",
"city": "AVON",
"state": "CT",
"postal_code": "060013659",
"telephone_number": "330-674-0874",
"fax_number": "860-674-8716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "IRA",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-01",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CT",
"license": "5835CT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.