Active NPI
Diamond Grady-Williams, DMD
- Pediatric Dentistry
- Tinley Park, IL
National Provider Identifier
1033784897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 019033547
- Practice address
- 7020 Centennial Dr
Tinley Park, IL 60477-1649 - Phone
- (708) 794-9526
- NPI assigned
- May 24, 2021
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 019033547 | IL | Primary |
Addresses
Primary practice location
7020 Centennial Dr
Tinley Park, IL 60477-1649
Mailing address
7020 Centennial Dr
Tinley Park, IL 60477-1649
Phone (708) 794-9526
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019033547 | IL | MD | Pediatric Dentist |
Interoperability endpoints
- dgradywilliams96111@uihealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718755200000",
"number": "1033784897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7020 CENTENNIAL DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771649",
"telephone_number": "708-794-9526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7020 CENTENNIAL DR",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604771649",
"telephone_number": "708-794-9526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY-WILLIAMS",
"first_name": "DIAMOND",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-24",
"last_updated": "2024-06-19",
"certification_date": "2024-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IL",
"license": "019033547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tinley Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.