Provider Demographics
NPI:1003356460
Name:GREENE, CAYLIN NICOLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAYLIN
Middle Name:NICOLE
Last Name:GREENE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-1209
Mailing Address - Country:US
Mailing Address - Phone:561-758-4791
Mailing Address - Fax:
Practice Address - Street 1:200 Q ST NE
Practice Address - Street 2:APT 2122
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2373
Practice Address - Country:US
Practice Address - Phone:561-758-4791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-06
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL375980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist