Stephen Duane Graham Sr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D.S. 4218 Issued in TN

Practice address

1602 South Holtzclaw Avenue
Chattanooga, TN 37404

Phone

(423) 698-5794

NPI assigned

May 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225259344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 24475",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374224475",
            "telephone_number": "423-595-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 SOUTH HOLTZCLAW AVENUE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-698-5794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "STEPHEN",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "D.S. 4218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "0107735",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Murel Graham, ACNP-BC
• Gordon D Graham, MD
• Jeffrey M Graham, DDS
• Linda Lewis Graham, LPC/MHSP
• Robert Matthew Graham, MD
• Zoe E Graham, RBT
• Jason Wayne Grajkowski
• Stoyan Grakov, M.D.
• Kristen Marie Granberry
• Grand Transport Services, Inc.

• General Practice Dentistry in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.