JOHN GREEN DENTISTRY PC (NPI# 1417240888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417240888 |
| Entity Type | Organization |
| Organization Name | JOHN GREEN DENTISTRY PC |
| Other Organization Name | MOUNTAIN RIDGE DENTAL |
| Practice Address |
1256 S State St Suite 103 Orem UT 84097-8237 |
| Practice Telephone | 8012247182 |
| Practice Fax Number | 8012350835 |
| Mailing Telephone | 8012247182 |
| Mailing Fax Number | 8012350835 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |
| Authorized Official Name | DR. JOHN GREEN (OWNER, DOCTOR) |
| Authorized Official Telephone | 8012247182 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
7692415-9922 | UT | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mountain Ridge Dental | Doing Business As Name - Organization |
| Street Address |
1256 S STATE ST SUITE 103 |
| City | OREM |
| State | UT |
| Zip Code | 84097-8237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457330458 | Mountain Ridge Dental, LLC | Dentist | 1256 S State St, Suite 103, Orem, UT 84097-8237 | 2006-01-10 |
| 1851792683 | Douglas Hansen | Dentist | 1256 S State St, Orem, UT 84097-8237 | 2014-09-11 |
| 1295033843 | Juan C. Chavez | Dentist | 1256 S State St, Suite 103, Orem, UT 84097-8237 | 2011-03-07 |
| 1104003102 | Ryan Schofield Wing | Dentist | 1256 S State St, Suite 103, Orem, UT 84097-8237 | 2008-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700392735 | Scott Harris | Chiropractor | 1425 S State St, Orem, UT 84097 | 2017-12-28 |
| 1457870990 | Summit Laboratory Services | Pathology | 1480 East 820 North, Orem, UT 84097 | 2017-09-15 |
| 1144759275 | White Smiles Family Dentistry | Clinic/Center | 594 E 800 S Suite G, Orem, UT 84097 | 2017-06-12 |
| 1801322367 | Mallory Hendrickson | Assistant Behavior Analyst | 744 E 1650 S, Orem, UT 84097 | 2017-05-03 |
| 1841648664 | National Vision, Inc. | Technician/Technologist | 545 E University Pkwy, Ste 103, Orem, UT 84097 | 2016-06-02 |
| 1538435045 | Wasatch Mental Health | Case Management | 1127 N 1450 E, Orem, UT 84097 | 2012-03-29 |
| 1366720104 | Deseret Counseling Inc | Social Worker | 1325 South 800 East, Suite 115 Room 115 B, Orem, UT 84097 | 2011-07-27 |
| 1598056053 | Uhs of Provo Canyon Inc | Psychiatric Residential Treatment Facility | 1350 E 750 North, Orem, UT 84097 | 2011-05-02 |
| 1659677219 | Francisco Xavier Ampuero | Counselor | 1015 So. State Street, Bsmt. Office, Orem, UT 84097 | 2011-01-31 |
| 1275835449 | Pursonna Tuiletufuga | Counselor | 1160 South Main Street, Suite 180a, Orem, UT 84097 | 2010-11-22 |
| Find all providers in zip 84097 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144759275 | White Smiles Family Dentistry | Clinic/Center | 594 E 800 S Suite G, Orem, UT 84097 | 2017-06-12 |
| 1760819924 | Grandpas Dental Center LLC | Clinic/Center | 294 W 800 N, Orem, UT 84057-3858 | 2013-10-02 |
| 1588937403 | Fld, LLC | Clinic/Center | 845 North 100 West, Suite 100, Orem, UT 84057 | 2012-02-23 |
| 1295883254 | Gary A. Carter, D.d.s., M.s., PC | Clinic/Center | 240 E University Pkwy, Orem, UT 84058-7601 | 2007-01-08 |
| 1184234460 | Nicolas K. Young, D.m.d., Inc. | Clinic/Center | 440 W 800 N, Orem, UT 84057-3728 | 2020-08-03 |
| 1720465875 | College Dental Clinic LLC | Clinic/Center | 1176 S 1480 W, Orem, UT 84058-4905 | 2015-04-28 |
| 1073924098 | Stonehaven Dental - Orem, LLC | Clinic/Center | 1802 N State St, Orem, UT 84057-2027 | 2014-05-13 |
| 1255657722 | Bestcare Dental LLC | Clinic/Center | 390 W 920 N, Orem, UT 84057-3042 | 2010-04-08 |
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| 1154947372 | Preston G. Hansen, Dds, Pllc | Clinic/Center | 7138 S Highland Dr Ste 211, Salt Lake City, UT 84121-3787 | 2020-06-23 |
| 1114549573 | Richfield Family Dental | Clinic/Center | 820 N Main St Ste 1, Richfield, UT 84701-1893 | 2020-05-08 |
| 1639790918 | Nic-utah County, LLC | Clinic/Center | 2230 N University Pkwy Ste 8b, Provo, UT 84604-6700 | 2020-04-28 |
| 1063032225 | Haven Dental LLC | Clinic/Center | 2685 N 1000 W, Pleasant View, UT 84414-2660 | 2020-04-17 |
| 1972139681 | Kayscreek Dental Pllc | Clinic/Center | 349 N Flint St, Kaysville, UT 84037-9807 | 2020-03-14 |
| 1831721240 | Sg Dental Pllc | Clinic/Center | 225 Skyhawk Dr, Wendover, UT 84083-4501 | 2020-02-05 |
| 1740829993 | V and S Dental LLC | Clinic/Center | 3816 W 13400 S Ste 200, Riverton, UT 84065-7888 | 2020-01-04 |
| 1124664834 | Simply Smiles Dental Utah | Clinic/Center | 2592 S 5600 W Ste 102, West Valley City, UT 84120-1274 | 2019-11-18 |
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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.