Kevan S Green, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

026191 Issued in OH

Practice address

133 W Hull Dr
Delaware, OH 43015-3703

Phone

(740) 363-3871

Fax

(740) 369-6616

NPI assigned

Jun 15, 2020

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

Practice roles

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

• Robert Green DDS Inc

  • General Practice Dentistry
  • Delaware, OH
  • NPI 1144289042
  NPD (past)

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1811512932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W HULL DR",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153703",
            "telephone_number": "740-363-3871",
            "fax_number": "740-369-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W HULL DR",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430153703",
            "telephone_number": "740-363-3871",
            "fax_number": "740-369-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KEVAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "026191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth C. Graffeo, M.D.
• Carrie Graffice
• Gene S Graham
• Rhonda Granger, SLP
• John Willock Green, MD
• Robert E. Green, D.D.S.
• Cassandra Natalie Grenade, M.D.
• Kevin Francis Gross, DO
• Mary Elizabeth Gross, LPN
• Abbey Grossmann

• General Practice Dentistry in Delaware, OH
• Providers in Delaware, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.