Dr. Jason Graves and Associates PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR. JASON GRAVES AND ASSOCIATES PA

Practice address

100 Pavilion Way Ste G
Southern Pines, NC 28387-4560

Phone

(910) 684-3687

Fax

(910) 401-1918

NPI assigned

Jun 18, 2020

Organization subpart

No

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

Authorized official

Name

Kris Reynolds

Title

Office Manager

Phone

(910) 684-3687

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• D Doing business as
• Dentistry of the Pines Doing business as

Locations

Practitioners 2

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

• Brady B George, DMD

  • General Practice Dentistry
  • Southern Pines, NC
  • NPI 1417565144
  NPD
• Jason Richard Graves, DMD

  • General Practice Dentistry
  • Southern Pines, NC
  • NPI 1891080339
  NPD

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592438400000",
    "number": "1023634730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PAVILION WAY STE G",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283874560",
            "telephone_number": "910-684-3687",
            "fax_number": "910-401-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PAVILION WAY STE G",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283874560",
            "telephone_number": "910-684-3687",
            "fax_number": "910-401-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JASON GRAVES AND ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-18",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-684-3687"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA DENTAL BOARD",
            "identifier": "9127",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dentistry of the Pines",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dustin J Donahue, LMBT #4824
• Deirdre Donoghue, MA CCC SLP
• Katherine Dooher, COTA/L
• Rivers Dorsey
• Valerie Downing
• Allie W Dryman, LMBT
• Irvin Dubose
• Kimberly Dubose
• Heather N Dunning, LCSW
• Breana Dutcher

• Dentist in Southern Pines, NC
• Providers in Southern Pines, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; 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.