DR. JAMES RUSSELL GREEN IV (NPI# 1396970653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396970653 |
| Entity Type | Individual |
| Full Name | DR. JAMES RUSSELL GREEN IV |
| Credential | DMD |
| Practice Address |
1309 W Fletcher Ave Tampa FL 33612 |
| Practice Telephone | 8139605540 |
| Mailing Telephone | 8139605540 |
| Mailing Fax Number | 8139611599 |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2018-03-27 |
| 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 |
18270 | FL | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
P64379 | NY | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | P64379 | NY | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346861572 | James Coleman Green | Student in an Organized Health Care Education/Training Program | 8312 Nw 115th St, Oklahoma City, OK 73162-2062 | 2020-04-28 |
| 1902369671 | James D Green | Nurse Practitioner | 501 E Carthage St, Meade, KS 67864 | 2019-04-10 |
| 1932637840 | James Green | Behavioral Analyst | 3307 Summit Dr, Bridgewater, MA 02324-2189 | 2017-05-23 |
| 1043618002 | James Green | Counselor | 2910 Royal Fern Ln, Charlotte, NC 28215-2877 | 2014-12-08 |
| 1730521113 | James William Green | Dermatology | 9108 Zyle Rd, Austin, TX 78737 | 2013-07-25 |
| 1871709840 | James Ellis Green | General Practice | 526 Pearl Nix Parkway, Suite #103, Gainesville, GA 30501 | 2007-05-15 |
| 1881814093 | James N. Green Jr. | Counselor | 4302 Clarks Valley Rd, Swords Creek, VA 24649 | 2007-04-27 |
| 1316066723 | James Royce Green | Dentist | 2200 Kell Blvd., Wichita Falls, TX 76309 | 2007-03-28 |
| 1902921299 | James Theodore Green Sr. | Counselor | 7400 S Racine Ave, Suite 101, Chicago, IL 60636-4114 | 2007-03-19 |
| 1033241856 | James J Green | Preventive Medicine | 3595 Crump Rd, Tallahassee, FL 32309-9291 | 2007-03-09 |
| Street Address |
1309 W FLETCHER AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093744823 | John P. Longmire IIi | Dentist | 1309 W Fletcher Ave, Tampa, FL 33612-3310 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| 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 |
|---|---|---|---|---|
| 1346862786 | Mikhail Daya Dmd Pa | Dentist | 500 Knights Run Ave Unit 1714, Tampa, FL 33602-6017 | 2020-05-08 |
| 1952871030 | Harvey Mossak Oral & Maxillofacial Surgery, Pllc | Dentist | 1211 E Kennedy Blvd Unit 223, Tampa, FL 33602-3559 | 2018-11-30 |
| 1316308547 | Renato J. Aves, LLC | Dentist | 7720 W Waters Ave, Tampa, FL 33615-1813 | 2016-03-16 |
| 1225350580 | Monteleone & Kessler, P.l. | Dentist | 4014 W. Estrella St., Suite B, Tampa, FL 33629 | 2010-02-26 |
| 1336322650 | Renato J Aves Jr. | Dentist | 7712 W Waters Ave, Tampa, FL 33615-1813 | 2007-12-10 |
| 1376681791 | Robert Orta | Dentist | 801 West Dr Martin Luther King Jr Blvd, Suite 2, Tampa, FL 33603 | 2007-02-01 |
| 1194878462 | Robert Orta Dds Pa | Dentist | 801 W Dr Martin Luther King Jr Blvd, Ste 2, Tampa, FL 33603 | 2007-01-19 |
| 1588745228 | Jeffrey Victor Moffett | Dentist | 275 Bayshore Blvd, 805, Tampa, FL 33606-2328 | 2006-10-18 |
| 1902909526 | David G Mcdonald | Dentist | 7001 N Dale Mabry, #7, Tampa, FL 33614 | 2006-09-07 |
| 1245333509 | Dale Salomon | Dentist | 14815 N Dale Mabry Hwy, Tampa, FL 33618-2027 | 2006-09-05 |
| Find all providers in TAMPA | ||||
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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.