Grace a. Warren DDS, Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GRACE A. WARREN DDS, CORP

Practice address

4110 Cedar Ave S
Minneapolis, MN 55407-3433

Phone

(612) 721-1272

Fax

(612) 721-1803

NPI assigned

Sep 11, 2020

Last updated

Oct 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Grace Ann Warren, DDSNPI 1174638613

Title

President

Phone

(612) 721-1272

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grace Ann Warren, DDS

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1174638613
  NPD Authorized official

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1215542618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073433",
            "telephone_number": "612-721-1272",
            "fax_number": "612-721-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 CEDAR AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073433",
            "telephone_number": "612-721-1272",
            "fax_number": "612-721-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE A. WARREN DDS, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-721-1272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143320200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gozy, PSYD, LP
• Angelynn Maire Grabau, MSN RN CNP
• John Neumann Graber, M.D.
• Lauren K Graber, M.D.
• Alec Christopher Grabinski, DDS
• Grace Group Home LLC
• Grace Therapy Center LLC
• Grace Travel LLC
• Colleen Marie Grace, PT
• Dixie Lee Grace, PH.D.

• Dental Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; 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.