Individual provider Active NPI

Grant W Butler, DMD

  • General Practice Dentistry
  • Grand Junction, CO
National Provider Identifier
1164738365
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
LL-226-10 Issued in NV
Practice address
2552 F Rd
Grand Junction, CO 81505-1422
Phone
(970) 241-1313
Fax
(970) 241-5202
NPI assigned
Aug 25, 2010
Last updated
Jul 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X LL-226-10 NV Primary
General Practice Dentistry 1223G0001X 10419 CO

Addresses

Primary practice location

2552 F Rd
Grand Junction, CO 81505-1422

Mailing address

2552 F Rd
Grand Junction, CO 81505-1422
Phone (970) 241-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20160115000107 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0749583318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10419COMDGeneral Practice Dentistry
LL-226-10NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Health Partners, Professional LLC Past Accepting new patients
Ruby Canyon Dental Group, PC General Practice Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1164738365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 F RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051422",
            "telephone_number": "970-241-1313",
            "fax_number": "970-241-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 F RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051422",
            "telephone_number": "970-241-1313",
            "fax_number": "970-241-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "GRANT",
        "middle_name": "W",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-08-25",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "LL-226-10",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10419",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.