Individual provider Active NPI

Alan Worth Grant, DDS

  • Dentist
  • Taylorsville, NC
National Provider Identifier
1174531164
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5667 Issued in NC
Practice address
167 1St Ave SW
Taylorsville, NC 28681
Phone
(828) 632-7008
NPI assigned
Aug 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5667 NC Primary

Addresses

Primary practice location

167 1St Ave SW
Taylorsville, NC 28681

Mailing address

PO Box 755
Taylorsville, NC 28681
Phone (828) 632-7008

Other identifiers 1

IdentifierTypeStateIssuer
8993359MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20150725012609 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6709199367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174531164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 755",
            "city": "TAYLORSVILLE",
            "state": "NC",
            "postal_code": "28681",
            "telephone_number": "828-632-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 1ST AVE SW",
            "city": "TAYLORSVILLE",
            "state": "NC",
            "postal_code": "28681",
            "telephone_number": "828-632-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ALAN",
        "middle_name": "WORTH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "5667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8993359",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, NC

Sources for this page

Verify at the official NPI Registry.