Colleen Davis Greene, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11105 Issued in KY

Practice address

496 Southland Dr
Lexington, KY 40503-1827

Phone

(828) 288-2425

Fax

(859) 288-7510

NPI assigned

Apr 16, 2018

Last updated

Jul 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Colleen Kelly Davis Former name

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

East Carolina University School of Dentistry, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Healthfirst Bluegrass Inc

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1538643036

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Healthfirst Bluegrass Inc

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1861840795

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Healthfirst Bluegrass Inc

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1922423359

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Healthfirst Bluegrass Inc.

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1215699467

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Healthfirst Bluegrass Inc.

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1447997044

  Corporate Officer, W-2 Managing Employee

  CMS ownership
• Healthfirst Bluegrass Inc.

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1881237220

  Corporate Officer, W-2 Managing Employee

  CMS ownership

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

• Healthfirst Bluegrass Inc

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1114932514
  Medicare reassignment NPD
• Healthfirst Bluegrass Inc.

  • Federally Qualified Health Center (FQHC)
  • Lexington, KY
  • NPI 1447997044
  NPD
• Interfaith Dental Clinic

  • Dentist
  • Nashville, TN
  • NPI 1811160781
  NPD (past)

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1811484900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "828-288-2425",
            "fax_number": "859-288-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "828-288-2425",
            "fax_number": "859-288-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "COLLEEN",
        "middle_name": "DAVIS",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "11105",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "DAVIS",
            "middle_name": "KELLY",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Travis Green, D.M.D.
• Richard Neil Greenberg, MD
• David Lloyd Greenburg, M.D.
• Greene Respiratory Services, Inc
• Andrew Todd Greene, DO
• Jared Tate Greene
• Jayme Brooke Greene, APRN
• Jeffrey Greene, PEER SUPPORT
• John F. Greene III, M.D.
• Kathrine Barrett Greene, DMD

• General Practice Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.