| Green Dental Medicine | |
|
180 Newport Center Dr Ste 230 Newport Beach CA 92660-0903 | |
| (949) 706-0777 | |
| (949) 734-7270 |
| Full Name | Green Dental Medicine |
|---|---|
| Speciality | Dentist |
| Location | 180 Newport Center Dr Ste 230, Newport Beach, California |
| Authorized Official Name and Position | Brian Green (OWNER) |
| Authorized Official Contact | 9497060777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Dental Medicine 280 Newport Center Dr Ste 230 Newport Beach CA 92660-7539 Ph: (949) 706-0777 | Green Dental Medicine 180 Newport Center Dr Ste 230 Newport Beach CA 92660-0903 Ph: (949) 706-0777 |
| NPI Number | 1518637156 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 4183022999 |
|---|---|
| Medicare Enrollment ID | O20211008001434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518637156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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