Active NPI
Scott William Grant, DMD
- Dentist
- Meridian, ID
National Provider Identifier
1194898767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D-3981
- Practice address
- 2275 S Eagle Rd Ste 140
Meridian, ID 83642-2620 - Phone
- (208) 938-3190
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D-3981 | ID | Primary |
Addresses
Primary practice location
2275 S Eagle Rd Ste 140
Meridian, ID 83642-2620
Mailing address
2275 S Eagle Rd Ste 140
Meridian, ID 83642-2620
Phone (208) 938-3190
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00001890338 | Other | ID | UNITED CONCORDIA |
| 000010157447 | Other | ID | BLUE SHIELD |
| 807480600 | Medicaid | ID | |
| 6P052 | Other | ID | BLUE CROSS |
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 |
|---|---|---|---|
| D-3981 | ID | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Company, PLLC | Dentist | Past | Accepting new patients |
| SW Grant PC | 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 and National Provider Directory roles.
-
- Dentist
- Boise, ID
- NPI 1689047904
-
- General Practice Dentistry
- Meridian, ID
- NPI 1881869055
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1194898767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2275 S EAGLE RD STE 140",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422620",
"telephone_number": "208-938-3190",
"fax_number": "208-888-1571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 S EAGLE RD STE 140",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422620",
"telephone_number": "208-938-3190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "SCOTT",
"middle_name": "WILLIAM",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "ID",
"license": "D-3981",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "00001890338",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010157447",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807480600",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "6P052",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.