John Carl Graf III, D.M.D.
Individual provider Active NPI General Practice Dentistry · Advance, MO
NPI 1154583987 · NPPES record last updated Jun 28, 2012
Key facts
- NPI
- 1154583987
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2011018803 (MO)
- Practice address
- 307 Gabriel St
Advance, MO 63730-0039 - Phone
- (573) 722-3044
- NPI assigned
- Jul 2, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 22, 2016 through Feb 22, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8610 | KY | MD | General Practice Dentistry |
| 2011018803 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. McCall, Currens, Ralston & Topor | General Practice | Past | Accepting new patients |
| Graf Family Dentistry, PSC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8610 | KY | |
| General Practice Dentistry | 1223G0001X | 2011018803 | MO | Yes |
Addresses
Primary practice location
307 Gabriel St
Advance, MO 63730-0039
Mailing address
307 Gabriel St
Advance, MO 63730-0039
Phone (573) 722-3044
Other names
- Dr. Trey Graf
Other providers in Advance, MO
- Cross Trails Medical Center
- Beverly Jaye Dillow
- Bruce J Dovin
- Sarah Dovin
- Suzana Gjino
- Lana S Green
- Haven Health Care Medical Clinic, Inc
- Haven Health Cares
- Inspiring Relationships Counseling
- Jerrilyn D Adkisson
All providers in Advance, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.