Emily Anne Latta Grisham, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

6215 Issued in AL

Practice address

4001 Balmoral Dr SW
Huntsville, AL 35801-6403

Phone

(256) 539-7447

NPI assigned

Jun 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective May 16, 2016 through May 16, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alabama Pediatric Dental Associates and Orthodontics

  • Pediatric Dentistry
  • Huntsville, AL
  • NPI 1851446595
  NPD (past)
• Professional Lane Dental Association

  • General Practice Dentistry
  • Dothan, AL
  • NPI 1871774851

  General Practice

  NPD (past)
• Professional Lane Dental, PLLC

  • Dental Clinic/Center
  • Dothan, AL
  • NPI 1508486424
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1114309705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-539-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-539-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6727 Highway 431 S",
            "address_purpose": "LOCATION",
            "city": "Owens Cross Roads",
            "state": "AL",
            "postal_code": "357639225",
            "country_code": "US",
            "telephone_number": "256-693-8900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 Hughes Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "AL",
            "postal_code": "357582220",
            "country_code": "US",
            "telephone_number": "256-772-7373",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2699 Sandlin Rd SW Ste B7",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356017343",
            "country_code": "US",
            "telephone_number": "256-280-9755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "EMILY",
        "middle_name": "ANNE LATTA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6215",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AL",
            "license": "6215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Harris Griffith, M.D.
• Thomas McKay Griggs, M.D.
• Mary Grimaud, LPC
• Julie Anne Grimes Mumfrey, M.D.
• Tara Grimes
• Sean Patrick Groark, M.D.
• Kerri Brooke Groce, LMT
• Sandra E Groger, OTD, OTR/L
• Brian Daniel Gross, LPC
• Laura Alan Grostick, M.D.

• All providers in Huntsville, AL
• Pediatric Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.