Grand View Dental Arts, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019024683 Issued in IL

Legal business name

GRAND VIEW DENTAL ARTS, LLC

Doing business as

Borden Dental Arts

Practice address

201 S Main St
Edwardsville, IL 62025-1921

Phone

(618) 656-4202

Fax

(618) 656-6580

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Charles Seymour Borden III, DDS

Title

Owner

Phone

(618) 656-4202

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Borden Dental Arts Doing business as

Locations

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1033631882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251921",
            "telephone_number": "618-656-4202",
            "fax_number": "618-656-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S MAIN ST",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251921",
            "telephone_number": "618-656-4202",
            "fax_number": "618-656-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VIEW DENTAL ARTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BORDEN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "SEYMOUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-656-4202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019024683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "1649322561",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Borden Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Borden Dental Arts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sabrina Gomez
• Haley Nichole Goodfellow, RD, LDN
• Daniel D Goran, M.D.
• Cassandra Gordon, OTR/L
• Morgan Graham, BEHAVIOR TECHNICIAN
• Lonn J Grandia, MD
• Julia Michelle Green, RN, SRNA
• Courtney Greenburg
• Tina Elizabeth Greenland, O.T.R./L
• Lily Grace Gregory

• Dental Clinic/Center in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.