DR. RAYMOND ALLAN GREEN (NPI# 1104934751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104934751 |
| Entity Type | Individual |
| Full Name | DR. RAYMOND ALLAN GREEN |
| Credential | DDS |
| Practice Address |
410 Mineral St South Boston VA 24592 |
| Mailing Address |
Po Box 269 South Boston VA 24592 |
| Practice Telephone | 4345724928 |
| Mailing Telephone | 4345724928 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0401005893 | VA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316416860 | Raymond B Green | Technician, Pathology | 1575 Elm St Ne, Conyers, GA 30012-3715 | 2018-11-14 |
| 1477686905 | Raymond Howard Green | Surgery | 4735 Ogletown Stanton Road, Medical Arts Pavilion 2, Suite 3301, Newark, DE 19713-2067 | 2007-03-13 |
| 1073539540 | Raymond Green | Counselor | 7827 Wise Ave, Baltimore, MD 21222-3339 | 2006-07-15 |
| Street Address |
410 MINERAL ST |
| City | SOUTH BOSTON |
| State | VA |
| Zip Code | 24592 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538698279 | Minkyeong Son | Dentist | 410 Mineral St, South Boston, VA 24592-3716 | 2017-06-07 |
| 1972824936 | Kwang W Kim | Dentist | 410 Mineral St, South Boston, VA 24592-3716 | 2010-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966398 | Transformations Center for Health Wellness LLC | Counselor | 2170 Sandy Beach Road, South Boston, VA 24592 | 2019-11-12 |
| 1740830215 | Kirstyn Lokker | Occupational Therapist | 1 High School Circle, South Boston, South Boston, VA 24592 | 2019-09-17 |
| 1841764248 | Nicole Ivey | Occupational Therapy Assistant | 103 Rosehil Rd, South Boston, VA 24592 | 2019-01-18 |
| 1841700960 | Bio-medical Applications of Virginia, Inc. | Clinic/Center | 130 Aubreys Loop, South Boston, VA 24592 | 2017-10-03 |
| 1659828820 | Family Preservation Services, Inc | Community/Behavioral Health | 1 High School Circle, South Boston, VA 24592 | 2016-09-06 |
| 1316222821 | Family and Children Enrichment Services Inc. | Health Maintenance Organization | 220 Paradise Lane, South Boston, VA 24592 | 2011-10-15 |
| 1326365578 | Brinda Howard | Nurse's Aide | 104 Love Shop Park Rd Lot #25, South Boston, VA 24592 | 2010-04-28 |
| 1356513543 | Betts Medical Supplies, LLC. | Durable Medical Equipment & Medical Supplies | 403 Factory Street, Suite B, South Boston, VA 24592 | 2008-03-27 |
| 1407051873 | Dominion Health Medical Assoc | Legal Medicine | 101 Aubrey's Loop Rd, South Boston, VA 24592 | 2007-06-18 |
| 1437352945 | Behavioral Health Associates, Inc. | Non-emergency Medical Transport (VAN) | 515 Yancey Ave, South Boston, VA 24592 | 2007-06-11 |
| Find all providers in zip 24592 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942711460 | Suhina Kapoor | Dentist | 385 W Broadway, South Boston, MA 02127-2217 | 2017-10-24 |
| 1194017871 | West Broadway Family Dental, LLC | Dentist | 385 West Broadway, South Boston, MA 02127 | 2011-05-12 |
| 1861530487 | Robert L. Plapp | Dentist | 3121 Bill Tuck Hwy, South Boston, VA 24592-6385 | 2007-02-03 |
| 1265539167 | Norman L Williams | Dentist | 1515 Noblin Ave, South Boston, VA 24592-2354 | 2006-09-20 |
| 1356358014 | Ben W Liu | Dentist | 591 E Broadway, South Boston, MA 02127 | 2006-08-02 |
| 1710991195 | Philip William Barber | Dentist | 29 Farragut Rd, Suite 2, South Boston, MA 02127-1714 | 2006-07-28 |
| 1942202023 | Edward Vance Geschelin | Dentist | 500 E Broadway, South Boston, MA 02127-4406 | 2005-06-02 |
| 1538698279 | Minkyeong Son | Dentist | 410 Mineral St, South Boston, VA 24592-3716 | 2017-06-07 |
| 1427581727 | Jonathan Foster | Dentist | 409 W Broadway, South Boston, MA 02127-2245 | 2017-04-04 |
| 1780941518 | Sang H Yu | Dentist | 431 Main St, South Boston, VA 24592-3241 | 2012-04-18 |
| Find all providers in SOUTH BOSTON | ||||
| City | SOUTH BOSTON |
| Zip Code | 24592 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.