Grant Severs, DMD MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021.003157 Issued in IL

Practice address

3915 Maine St Ste 2
Quincy, IL 62305-5843

Phone

(217) 919-5008

NPI assigned

Jul 18, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Severs Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Quincy, IL
  • NPI 1972377174
  NPD Authorized official

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1144955790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 N 30TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623013737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 MAINE ST STE 2",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055843",
            "telephone_number": "217-919-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVERS",
        "first_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "DMD MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-18",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021.003157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Seals
• Nathan P. Seaman, D.O.
• Senior Care of Quincy LLC
• Serenity Sleep Solutions of Quincy, LLC
• Severs Orthodontics LLC
• Christopher Trey Sexton, LCSW
• Laurel Sexton, NP-C
• SH Care, LLC
• Kristin Shaffer, PT
• Ruchi Shah, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Quincy, IL
• Providers in Quincy, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.

Verify at the official NPI Registry.