Matthew Grace, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30947 Issued in TX

Practice address

299 Quail St
Van, TX 75790-3841

Phone

(903) 963-8681

NPI assigned

Jun 28, 2015

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 28, 2015.

{
    "created_epoch": "1435449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435449600000",
    "number": "1083096820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 QUAIL ST",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757903841",
            "telephone_number": "903-963-8681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 QUAIL ST",
            "city": "VAN",
            "state": "TX",
            "postal_code": "757903841",
            "telephone_number": "903-963-8681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "MATTHEW",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-28",
        "last_updated": "2015-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "30947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Country Inn Healthcare
• Angela Elske McFarland Davis, LPC-ASSOCIATE
• Thomas Jason Dodd, MED, LAT, ATC
• East Texas Medical Center Quitman
• Stephanie Renee Garland, MS CCC SLP
• William Kelly Grizzard
• Health at Home Inc
• Nancy Kathryn Hopper
• Lindsay Delea Jones, M.S., LPC
• Cheryl May Mackey, LPC

• All providers in Van, TX
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2015; 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.