Provider Demographics
NPI:1346462421
Name:DR. JAMES G. GREENE, D.D.S., INC.
Entity Type:Organization
Organization Name:DR. JAMES G. GREENE, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GENERAL
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-721-0500
Mailing Address - Street 1:11900 SHAKER BLVD FL 2
Mailing Address - Street 2:SAME AS
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-1925
Mailing Address - Country:US
Mailing Address - Phone:216-721-0500
Mailing Address - Fax:216-721-0523
Practice Address - Street 1:11900 SHAKER BLVD FL 2
Practice Address - Street 2:SAME AS
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-1925
Practice Address - Country:US
Practice Address - Phone:216-721-0500
Practice Address - Fax:216-721-0523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH104231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty