Kathryn A Grady, D.D.S., M.S.

Primary specialty

DentistTaxonomy code 122300000X

License

15932 Issued in NJ

Practice address

102 I Centre Boulevard
Marlton Crossing
Marlton, NJ 08053

Phone

(856) 985-6808

Fax

(856) 985-2792

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013132224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 I CENTRE BOULEVARD",
            "address_2": "MARLTON CROSSING",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-985-6808",
            "fax_number": "856-985-2792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 I CENTRE BOULEVARD",
            "address_2": "MARLTON CROSSING",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "08053",
            "telephone_number": "856-985-6808",
            "fax_number": "856-985-2792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "15932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jana L Gordon, LCSW
• Matthew Gordon, MD
• Lauren D Gotay, M.D.
• Michele Lynn Gould-Grabarski, MA, CCC-SLP
• Stuart D Gould, M.D.
• Charles Graham, MSW
• Malvina Granovskaya, MS CCC-SLP
• Deanna Lynn Gray-Miceli, PHD., GNP-BC
• Greater New Jersey Creative Counseling
• Greater New Jersey Creative Counseling Inc

• Dentist in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.