G.Gary Green DMD, PA Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

12168 Issued in NJ

Legal business name

G.GARY GREEN DMD, PA INC

Practice address

277 Bloomfield Ave
Caldwell, NJ 07006-5104

Phone

(973) 228-0252

Fax

(973) 228-0918

NPI assigned

Jun 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Gail Gary Green Jr., DMD

Title

Peresident/Owner

Phone

(973) 228-0252

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1912427295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 BLOOMFIELD AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065104",
            "telephone_number": "973-228-0252",
            "fax_number": "973-228-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 BLOOMFIELD AVE",
            "city": "CALDWELL",
            "state": "NJ",
            "postal_code": "070065104",
            "telephone_number": "973-228-0252",
            "fax_number": "973-228-0918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 Galloway Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "NY",
            "postal_code": "109901719",
            "country_code": "US",
            "telephone_number": "845-986-8846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "G.GARY GREEN DMD, PA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "PERESIDENT/OWNER",
        "authorized_official_telephone_number": "973-228-0252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "12168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Daniel Evangelista, LCSW, LCADC
• Katie Jo Facto
• Marline Francois, LCSW
• Frank and Angie LLC
• Lisa Frank
• Mamatha Reddy Gadarla, M.D.
• Cynthia Ann Gallagher, OTR
• Toni E Gialanella, DC
• Gohewec Healthcare Providers
• Mindy Ilene Golin, MA

• Dental Clinic/Center in Caldwell, NJ
• Providers in Caldwell, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.