Provider Demographics
NPI:1356316137
Name:GREEN, STEVEN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:GREEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8919 PARALLEL PKWY
Mailing Address - Street 2:SUITE 480
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1636
Mailing Address - Country:US
Mailing Address - Phone:913-334-6000
Mailing Address - Fax:913-334-7990
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:SUITE 480
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1636
Practice Address - Country:US
Practice Address - Phone:913-334-6000
Practice Address - Fax:913-334-7990
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS71131223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSU70556Medicare UPIN
KSD698368Medicare ID - Type UnspecifiedMEDICARE ID KC/OP OFFICE