Edward W Grimes DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

2748 Issued in OK

Legal business name

EDWARD W GRIMES DDS INC

Practice address

6112 E 61St St
Tulsa, OK 74136

Phone

(918) 492-9415

Fax

(918) 492-3377

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Edward W Grimes, DDS

Title

Owner

Phone

(918) 492-9415

Specialties & licenses 2

Addresses

Other names 1

• Endodontic Associates of Tulsa Other name

Locations

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1205095270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6112 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-492-9415",
            "fax_number": "918-492-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6112 E 61ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74136",
            "telephone_number": "918-492-9415",
            "fax_number": "918-492-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD W GRIMES DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "GRIMES",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-492-9415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OK",
            "license": "2748",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "OK",
            "license": "3",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endodontic Associates of Tulsa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Candice Louise Edwards-Thomas
• Benjamin C Edwards, RN
• Charyl Edwards
• Dorthine Edwards, LPN
• Grace Yvonne Edwards

• Dentist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Dentist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.