Gary Wayne Green is a Periodontics in Encino, California. Gary Wayne Green practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Gary Wayne Green is 1992748529. The last update date is 2011-09-05.
Gary Wayne Green's current location address is 16133 Ventura Blvd, Encino, California. You can contact this provider via phone number 8189950294 and fax number 8189957549. The mailing address for Gary Wayne Green is 16133 Ventura Blvd, Encino, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary Wayne Green |
|---|---|
| Address | 16133 Ventura Blvd, Encino, California |
| Phone Number | 8189950294 |
| Fax Number | 8189957549 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1992748529 |
|---|---|
| Provider Enumeration Date | 2006-06-13 |
| Last Updated Date | 2011-09-05 |
Provider Mailing Address Detail
| Address | 16133 Ventura Blvd |
|---|---|
| City | Encino |
| State | California (CA) |
| Post Code | 914362403 |
| Phone Number | 8189950294 |
| Fax Number | 8189957549 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 22605 |
|
Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 954297884 | CA | CORP ID # |
Post Comment/ Review Below
What is the unique identifier code issued to Gary Wayne Green by the Centers for Medicare & Medicaid Services (CMS)?
The Gary Wayne Green has been assigned the NPI (National Provider Identifier) 1992748529. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Gary Wayne Green is physically located?
The Gary Wayne Green is physically situated at the following address: 16133 Ventura Blvd, Encino, CA, 914362403.
What is the Gary Wayne Green's specialty and taxonomy code?
The Gary Wayne Green's specialty is Periodontics, and the corresponding taxonomy code is 1223P0300X.
On what date did Gary Wayne Green receive its 1992748529 assignment from the Centers for Medicare & Medicaid Services?
The Gary Wayne Green was assigned its 1992748529 on 2006-06-13, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Gary Wayne Green last refreshed?
The information related to the Gary Wayne Green, including its address, specialty, and other relevant details, was last updated on 2011-09-05.