NPIMap

Organization Active NPI

Grand Family Dentistry. Com

  • Dentist
  • Mandeville, LA
National Provider Identifier
1225156391
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
122300000X Issued in LA
Legal business name
GRAND FAMILY DENTISTRY. COM
Practice address
2083 3Rd St
Mandeville, LA 70471-6426
Phone
(985) 231-5796
Fax
(985) 624-8881
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Authorized official

Name
Dr. William Bradley Grand, D.D.S.NPI 1164523213
Title
President
Phone
(985) 778-0096

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 122300000X LA Primary

Addresses

Primary practice location

2083 3Rd St
Mandeville, LA 70471-6426

Mailing address

700 Asbury Dr
Mandeville, LA 70471-1844
Phone (985) 231-5796

National Provider Directory

National Provider Directory

Locations

2083 3rd St
Mandeville, LA 70471
Phone (985) 231-5796

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476662400000",
    "number": "1225156391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ASBURY DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711844",
            "telephone_number": "985-231-5796",
            "fax_number": "985-624-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2083 3RD ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704716426",
            "telephone_number": "985-231-5796",
            "fax_number": "985-624-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND FAMILY DENTISTRY. COM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2016-10-17",
        "status": "A",
        "authorized_official_last_name": "GRAND",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-778-0096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "122300000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; 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.