Randi Green D.M.D., LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2011012315 Issued in MO

Legal business name

RANDI GREEN D.M.D., LLC

Practice address

2053 S Waverly Ave Ste E
Springfield, MO 65804-2497

Phone

(417) 887-5155

Fax

(417) 823-7497

NPI assigned

May 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Randi C. Green, D.M.D

Title

Owner/ Dentist

Phone

(417) 887-5155

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brenda Phillips Herrman, DDS

  • General Practice Dentistry
  • Seneca, MO
  • NPI 1689774200
  NPD (past)

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304985600000",
    "number": "1942592977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 S WAVERLY AVE STE E",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042497",
            "telephone_number": "417-887-5155",
            "fax_number": "417-823-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2053 S WAVERLY AVE STE E",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042497",
            "telephone_number": "417-887-5155",
            "fax_number": "417-823-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDI GREEN D.M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2011-05-10",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "RANDI",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/ DENTIST",
        "authorized_official_telephone_number": "417-887-5155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2011012315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pranav R Rana, MD
• David Awrey Randall, M.D.
• Geronn Randall
• Zachary Randall, MD
• Puneet Kaur Randhawa, M.D.
• Alison N Randol
• Kerry Randolph, M.D.
• William Jarad Raney, MD
• Nathen David Ransom, LPC
• Donald Raphael, DDS

• General Practice Dentistry in Springfield, MO
• Providers in Springfield, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.