MARK A GREEN (NPI# 1821352394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821352394 |
| Entity Type | Individual |
| Full Name | MARK A GREEN |
| Credential | DDS |
| Practice Address |
300 Longwood Ave Boston MA 02115-5724 |
| Practice Telephone | 6173556000 |
| Mailing Telephone | 6173556000 |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2020-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DN1857060 | MA | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | DL-11520 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 33 Bartlett St, Lowell, MA 018521334 | 9784545637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902342165 | Mark Green | Specialist/Technologist | 339 Nacoochee Dr, Rabun Gap, GA 30568-2200 | 2017-01-12 |
| 1215293261 | Mark S Green | Pharmacist | 923 W Central Park Ave, Davenport, IA 52804-1802 | 2012-04-04 |
| 1811123862 | Mark Ryan Green | Physical Therapist | 29185 Highway 191, Many, LA 71449-6313 | 2009-06-04 |
| 1770785925 | Mark Daniel Green | Dentist | 415 1st St E, Humble, TX 77338-4602 | 2007-06-01 |
| 1386760981 | Mark R Green | Dentist | 108 Vail St, Middlesex, NJ 08846-1943 | 2007-03-22 |
| 1609968544 | Mark Allen Green | Chiropractor | 2137 Dixie Hwy, Louisville, KY 40210-2242 | 2006-09-28 |
| 1841209962 | Mark Raymond Green | Dentist | 2201 Lincoln Way West, South Bend, IN 46628-2513 | 2006-08-07 |
| 1154395044 | Mark Ellison Green | Internal Medicine | 370 Bmh Physicians Office Bldg, Maryville, TN 37804-5819 | 2006-02-15 |
| 1396736336 | Mark S Green | Physician Assistant | 10040 Two Notch Rd, Columbia, SC 29223-4396 | 2005-10-31 |
| 1083162424 | Mark Green | Pharmacist | 731 Cherry Dr, Hershey, PA 17033-2099 | 2016-09-14 |
| Street Address |
300 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667539 | Barry Grant Zallen | Pediatrics | 300 Longwood Ave, Children's Hospital, Au 105, Boston, MA 02115-5724 | 2005-05-23 |
| 1730780669 | Hannah Fraser | Registered Nurse | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-06 |
| 1164023776 | Hannah Brewer | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-02 |
| 1104423680 | Justin Matthias Hintze | Otolaryngology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-10-07 |
| 1295340388 | Kathryn Theresa Moffa | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1144835224 | Abby Elizabeth Bandi | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1558976845 | Hilary Segar Garber | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 |
| 1063026003 | Lauren M Dilullo | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-08 |
| 1013521004 | Carl Britto | Student in an Organized Health Care Education/Training Program | 300 Longwood Ave, Boston, MA 02115-5737 | 2020-09-07 |
| 1760096887 | Rebecca Marie Leslie | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528592029 | Jaegak Kim | Dentist | 850 Harrison Ave Fl 6, Boston, MA 02118-4001 | 2017-04-12 |
| 1053750893 | Allan Wun | Dentist | 1 Kneeland St., 5th Floor/ Dhs 503, Boston, MA 02111 | 2013-06-14 |
| 1609189018 | Stavros Oikonomou | Dentist | 660 Washington St Apt 25g, Boston, MA 02111-3243 | 2010-07-15 |
| 1073825352 | Cristobal Alberto Quevedo | Dentist | 761 Harrison Ave Apt 205, Boston, MA 02118-2362 | 2010-07-02 |
| 1740591080 | Ahmad Ali Alshadwi | Dentist | 850 Harrison Ave Fl Acc5, Boston Medical Center Oral Surgery Department, Boston, MA 02118-4001 | 2010-07-01 |
| 1437390481 | Behzad Mostoufi | Dentist | 820 Harrison Ave # Acc5, Boston, MA 02118-2905 | 2009-03-19 |
| 1396991089 | Jennifer E. Smith-williams, D.m.d. | Dentist | 575 Boylston St Fl 5, Boston, MA 02116-3607 | 2008-08-13 |
| 1497923791 | Mario S Lucca | Dentist | 185 Dartmouth St Ste 403, Boston, MA 02116-5883 | 2008-02-20 |
| 1225228422 | Steven John Scrivani | Dentist | One Kneeland Street, Suite 601, Boston, MA 02111 | 2007-07-25 |
| 1215138672 | Constantinos Laskarides | Dentist | 1 Kneeland St Rm 503, Boston, MA 02111-1527 | 2007-05-31 |
| Find all providers in BOSTON | ||||
Please comment or provide details below to improve the information on MARK A GREEN.
| 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.