NPIMap

Organization Active NPI

Dr. Ronald a. Grace, DDS PLLC

Doing business as Grace Dental Care

  • General Practice Dentistry
  • Chelyan, WV
National Provider Identifier
1043707334
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2678 Issued in WV
Legal business name
DR. RONALD A. GRACE, DDS PLLC
Doing business as
Grace Dental Care
Practice address
15081 Maccorkle Ave
Chelyan, WV 25035
Phone
(304) 595-3551
Fax
(304) 595-6822
NPI assigned
Apr 23, 2018
Last updated
Apr 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Authorized official

Name
Dr. Ronald A Grace, DDSNPI 1801931019
Title
Dentist
Phone
(304) 595-3551

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2678 WV Primary

Addresses

Primary practice location

15081 Maccorkle Ave
Chelyan, WV 25035

Mailing address

PO Box 40
Cabin Creek, WV 25035-0040
Phone (304) 595-3551

Other identifiers 1

IdentifierTypeStateIssuer
0137007000MedicaidWV

Other names 1

  • Grace Dental Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1043707334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "CABIN CREEK",
            "state": "WV",
            "postal_code": "250350040",
            "telephone_number": "304-595-3551",
            "fax_number": "304-595-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15081 MACCORKLE AVE",
            "city": "CHELYAN",
            "state": "WV",
            "postal_code": "25035",
            "telephone_number": "304-595-3551",
            "fax_number": "304-595-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RONALD A. GRACE, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "304-595-3551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137007000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grace Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chelyan, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.