Gregory M. Graham, DMD,LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DN010029 Issued in GA

Legal business name

GREGORY M. GRAHAM, DMD,LLC

Practice address

385 Meadow Ridge Drive
Gregory M Graham, DMD, LLC
Milledgeville, GA 31061-8741

Phone

(478) 452-0270

Fax

(478) 454-1068

NPI assigned

Mar 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Gregory M. Graham, DMD

Title

Doctor/Owner

Phone

(478) 452-0270

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1073785986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 MEADOW RIDGE DR",
            "address_2": "GREGORY M GRAHAM, DMD, LLC",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310618741",
            "telephone_number": "478-452-0270",
            "fax_number": "478-454-1068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 MEADOW RIDGE DRIVE",
            "address_2": "GREGORY M GRAHAM, DMD, LLC",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310618741",
            "telephone_number": "478-452-0270",
            "fax_number": "478-454-1068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY M. GRAHAM, DMD,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "478-452-0270",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "GA",
            "license": "DN010029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00289341B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Claire Greenway
• Ernestine Griffin
• John E. Griffin III, D.P.T., PT
• Kimberly Lynn Griffin, FNP-C
• Kelly R Grimes, PT
• Emmett Lee Griswold

• Dental Clinic/Center in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Dental Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.