Kalleb Anderson Greene, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9989 Issued in KY

Practice address

318 Cool Water CT Ste a
Hopkinsville, KY 42240-8781

Phone

(270) 885-6137

NPI assigned

Aug 16, 2017

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

Locations

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.

• Kalleb a. Greene Family Dentistry

  • General Practice Dentistry
  • Hopkinsville, KY
  • NPI 1972024115
  NPD Authorized official

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1922524503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 COOL WATER CT STE A",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408781",
            "telephone_number": "270-885-6137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 COOL WATER CT STE A",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408781",
            "telephone_number": "270-885-6137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 S Main St",
            "address_purpose": "LOCATION",
            "city": "Elkton",
            "state": "KY",
            "postal_code": "422208808",
            "country_code": "US",
            "telephone_number": "270-265-5140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREENE",
        "first_name": "KALLEB",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicente Grayman
• Laquisha Shante Green
• Sherri Bonchele Green, LPC-A
• David Keith Greene Jr., DMD
• Judy A. Greene, P.T.
• Vanessa Greene
• Sierra Greenwade
• Katherine Chandler Greenwell
• Kristi Annette Griffey
• Mary Ashley Griffin

• General Practice Dentistry in Hopkinsville, KY
• Providers in Hopkinsville, 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 Jan 17, 2023; 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.