Active NPI 1972614717 Individual Practitioner Male Practitioner

Dr. Douglas Green , DDS

Dentist - General Practice • Blaine, MN

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Green, DDS is a registered healthcare professional specializing in Dentist - General Practice in Blaine, MN. Practice services are available at 10729 TOWN SQUARE DR NE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

10729 Town Square Dr Ne
#150

Blaine, MN 55449

Telephone 7632698650

Fax 7632013377

Associated Practice Facility / Clinic

🏢 Imagine Smiles Facility NPI 1174133698

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Blaine, MN

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 33.3 Yrs

Regional Practice Density

32 Specialists

Practicing in Blaine, MN (2262 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-08-05

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MN D11370

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Noah Henrichsen

Dentist

NPI 1598698367

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

📍

Updated Practice Location August 05, 2020

Registered at 10729 TOWN SQUARE DR NE, #150, BLAINE, MN 55449 (Tel: 7632698650)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 10756 BUTTERNUT ST NW, COON RAPIDS, MN 554484448 (Tel: 7637574170)

📍

Updated Business Mailing Address July 08, 2007

Registered at 2826 ASPEN LAKE DR NE, BLAINE, MN 554493100 (Tel: 6129649172)

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Provider Name / Credentials Updated July 08, 2007

Recorded as DOUGLAS GREEN, DDS

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #D11370 in MN)

🟢

Initial NPI Registration & Enumeration August 31, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1972614717

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 31, 2006

Last Update: August 05, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2826 Aspen Lake Dr Ne

Blaine, MN 554493100

Phone: 6129649172

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.