Jessica Tanya Greene

Primary specialty

Dental TherapistTaxonomy code 125J00000X

License

25-0001-DHAT Issued in WA

Practice address

32020 Little Boston Rd NE
Kingston, WA 98346-9734

Phone

(360) 297-2840

NPI assigned

Sep 4, 2025

Sex

Female

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

Interoperability endpoints

• Direct secure messaging: jessica.greene.p1@direct.pgsklallamtribe.nextgenshare.com

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.

• Port Gamble S'Klallam Tribe

  • Federally Qualified Health Center (FQHC)
  • Kingston, WA
  • NPI 1760428650
  NPD

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

{
    "created_epoch": "1756944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1982584595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32020 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32020 LITTLE BOSTON RD NE",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983469734",
            "telephone_number": "360-297-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JESSICA",
        "middle_name": "TANYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-04",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "125J00000X",
            "taxonomy_group": "",
            "desc": "Dental Therapist",
            "state": "WA",
            "license": "25-0001-DHAT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sahibjit S Gill, D.C
• Jason Raydr-Scott Gomez, SUDP
• Deanna Griffeth, RC, CDP
• Sean Patrick Guinan, L.AC.
• Crystal Gurney
• Heather Hagerup
• Cindy Pamela Haines, LMP

• All providers in Kingston, WA
• Dental Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; 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.