Active NPI
Jessica Gradoville, DDS
- Dentist
- Lincoln, NE
National Provider Identifier
1023564374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7331
- Practice address
- 40TH and Holdrege St
Lincoln, NE 68503 - Phone
- (402) 472-3249
- NPI assigned
- Aug 28, 2016
- Last updated
- Aug 28, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7331 | NE | Primary |
Addresses
Primary practice location
40TH and Holdrege St
Lincoln, NE 68503
Mailing address
4201 N 18TH St
Lincoln, NE 68521-1623
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472342400000",
"number": "1023564374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 N 18TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685211623"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40TH AND HOLDREGE ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "68503",
"telephone_number": "402-472-3249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADOVILLE",
"first_name": "JESSICA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-28",
"last_updated": "2016-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "7331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.