Jenna Warlick Graham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6069 Issued in LA

Practice address

1005 Avenue Saint Germain
Covington, LA 70433-6440

Phone

(318) 376-0236

NPI assigned

Jun 11, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1104146208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 AVENUE SAINT GERMAIN",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704336440",
            "telephone_number": "318-376-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 AVENUE SAINT GERMAIN",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704336440",
            "telephone_number": "318-376-0236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JENNA",
        "middle_name": "WARLICK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly C Grady, NP
• Grae Holdings LLC
• Anastasia K Graffagnini, MD
• Allison Marie Graffeo
• Celeste A Graham
• Mark F Graham, ED.D., LPC-S
• Tiffany Graham
• Katelyn Grammes
• Kristen Graves
• Valerie Grayson

• General Practice Dentistry in Covington, LA
• Providers in Covington, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.