NPIMap

Organization Active NPI

Grady Dental Care LLC

  • Dental Clinic/Center
  • Johns Creek, GA
National Provider Identifier
1003404245
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GRADY DENTAL CARE LLC
Practice address
10710 Medlock Bridge Rd Ste 101
Johns Creek, GA 30097-1998
Phone
(678) 957-0770
NPI assigned
Jan 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sean GradyNPI 1295744407
Title
Owner DDS
Phone
(678) 957-0770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

10710 Medlock Bridge Rd Ste 101
Johns Creek, GA 30097-1998

Mailing address

10710 Medlock Bridge Rd Ste 101
Johns Creek, GA 30097-1998
Phone (678) 957-0770

National Provider Directory

National Provider Directory

Locations

10710 Medlock Bridge Rd
Ste 101
Johns Creek, GA 30097
Phone (678) 957-0770

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1003404245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971998",
            "telephone_number": "678-957-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 MEDLOCK BRIDGE RD STE 101",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300971998",
            "telephone_number": "678-957-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "678-957-0770"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.