MEDICARE: DR. CHRISTINA GREENE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	33164	TX
2	122300000X	Dentist	33164	TX

General Provider Information

NPI Number	:	1275046484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA GREENE DDS

Provider Business Mailing Address
First Line	:	8468 N RIVERSIDE DR STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-9694
Country	:	US
Telephone Number	:	214-218-0248
Fax Number	:	817-656-9089

Provider Business Practice Location Address
First Line	:	8468 N RIVERSIDE DR STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-9694
Country	:	US
Telephone Number	:	214-218-0248
Fax Number	:	817-656-9089

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2017
Last Update Date	:	10/14/2025

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