Active NPI
William D. McGrady, D.M.D.
- Endodontics
- Fort Myers, FL
National Provider Identifier
1093886772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DN12633
- Practice address
- 12734 Kenwood LN Ste 66
Fort Myers, FL 33907-5638 - Phone
- (239) 926-4727
- Fax
- (239) 936-4193
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DN12633 | FL | Primary |
Addresses
Primary practice location
12734 Kenwood LN Ste 66
Fort Myers, FL 33907-5638
Mailing address
12734 Kenwood LN Ste 66
Fort Myers, FL 33907-5638
Phone (239) 936-4727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12633 | Other | FL | DENTAL LICENSE |
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 |
|---|---|---|---|
| DN12633 | FL | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1093886772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12734 KENWOOD LN STE 66",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339075638",
"telephone_number": "239-936-4727",
"fax_number": "239-936-4193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12734 KENWOOD LN STE 66",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339075638",
"telephone_number": "239-926-4727",
"fax_number": "239-936-4193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGRADY",
"first_name": "WILLIAM",
"middle_name": "D.",
"name_prefix": "Miss",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "FL",
"license": "DN12633",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "12633",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.