Larry Paul Green Sr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

M594 Issued in SD

Practice address

102 N Egan Ave
Madison, SD 57042

Phone

(605) 256-4969

Fax

(605) 256-4717

NPI assigned

Nov 6, 2006

Last updated

May 15, 2023By the provider in NPPES

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

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Larry P. Green DDS Inc., PC

  • Dentist
  • Madison, SD
  • NPI 1760179519
  NPD Authorized official

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1912076985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 243 102 N EGAN AVE",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "57042",
            "telephone_number": "605-256-4969",
            "fax_number": "605-256-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 N EGAN AVE",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "57042",
            "telephone_number": "605-256-4969",
            "fax_number": "605-256-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LARRY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "M594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin K Fox, PT
• Edgar V Garcia, LMT
• Getting Well Chiropractic Prof, LLC
• Bradley Dale Gilbert, ATC
• Joseph Michael Gitzen, D.C.
• Sydney Layne Gustaf, DPT
• Heather Hagberg
• Kari Ann Hall, MA, ATC
• Cooper Robert Hausmann, DPT
• Bernard F Heilman, M.D.

• Dentist in Madison, SD
• Providers in Madison, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.