Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ivan L Green

Individual provider General Practice Dentistry · NPI 1053615831

Dr. Ivan L Green is a General Practice Dentistry in Roseville, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2011
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Practice location Address checks out

19551 E 10 Mile Rd
Roseville, MI 48066-3998
Phone: (586) 775-6770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 2901009700 (MI)

Record details

NPI number1053615831
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 7, 2011
Last updated in NPPESJanuary 7, 2011
Mailing address29961 Northbrook St, Farmington Hills, MI 48334-2328

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