Matthew D Grace DDS, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MATTHEW D GRACE DDS, PLLC

Practice address

5621 S Broadway Ave
Tyler, TX 75703-4348

Phone

(903) 630-6313

NPI assigned

Dec 6, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Matthew D Grace, DDS

Title

Dentist

Phone

(903) 316-9419

Specialties & licenses 1

Addresses

Other names 1

• Broadway Dental Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohammad Arif, DDS

  • Dentist
  • Tyler, TX
  • NPI 1831531896
  NPD (past)

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1104397868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 VZCR 1519",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751405744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5621 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034348",
            "telephone_number": "903-630-6313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW D GRACE DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "903-316-9419",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Annisa Mathew, DO
• Sherry Mathew, PHARMD
• Jaimie Leigh Mathews
• Brook Mathis, LPC
• Rhonda F Mathis, ACNP
• Joyce Matthews-Huddleston
• Ellen Matthews
• Heather Elizabeth Matthews, RN, BSN
• Jeffery R Matthews, MD
• Jonathan Trevor Matthews, FNP-C

• Dental Clinic/Center in Tyler, TX
• Providers in Tyler, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.