Mark a Grimes DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401006539 Issued in VA

Legal business name

MARK A GRIMES DDS PC

Practice address

4437 Brookfield Corporate Drive
#107
Chantilly, VA 20151

Phone

(703) 222-5400

Fax

(703) 222-0470

NPI assigned

Apr 22, 2008

Last updated

Apr 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Grimes, DDSNPI 1699114496

Title

President

Phone

(703) 222-5400

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark A Grimes, D.D.S.

  • General Practice Dentistry
  • Chantilly, VA
  • NPI 1699114496
  NPD (past) Authorized official

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1033383047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 BROOKFIELD CORPORATE DRIVE",
            "address_2": "#107",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "20151",
            "telephone_number": "703-222-5400",
            "fax_number": "703-222-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4437 BROOKFIELD CORPORATE DRIVE",
            "address_2": "#107",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "20151",
            "telephone_number": "703-222-5400",
            "fax_number": "703-222-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A GRIMES DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-222-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401006539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Major
• Mala a Britto DDS PC
• Rohini Manda, MD
• Sonnette Stone Manry, RN
• Larisa Ayn Manzo, BCBA
• Allison M Marquardt, LCSW
• Laura Marquez
• Martha Marroquin, BEHAVIOR TECHNICIAN
• Abby Marshall
• Nicole Marshall, LCSW

• General Practice Dentistry in Chantilly, VA
• Providers in Chantilly, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.