Active NPI
Lorenda L. Grace, DDS
- Dental Anesthesiology
- Irving, TX
National Provider Identifier
1184830077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- 17194
- Practice address
- 6565 N Macarthur Blvd
225
Irving, TX 75039-2461 - Phone
- (214) 677-8542
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Anesthesiology | 1223D0004X | 17194 | TX | Primary |
Addresses
Primary practice location
6565 N Macarthur Blvd
225
Irving, TX 75039-2461
Mailing address
PO Box 631606
Irving, TX 75063-0025
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-3906587 | Other | TX | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17194 | TX | MD | Dentist Anesthesiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1184830077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631606",
"city": "IRVING",
"state": "TX",
"postal_code": "750630025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6565 N MACARTHUR BLVD",
"address_2": "225",
"city": "IRVING",
"state": "TX",
"postal_code": "750392461",
"telephone_number": "214-677-8542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRACE",
"first_name": "LORENDA",
"middle_name": "L.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "TX",
"license": "17194",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "20-3906587",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.