Grant Carlos McSurdy, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS039018 Issued in PA

Practice address

2107B Cottman Ave
Philadelphia, PA 19149-1122

Phone

(215) 235-4060

NPI assigned

Mar 22, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Dental Dreams, LLC

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1104059534
  NPD (past)

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1225304355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W ERIE ST STE 200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606546920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107B COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491122",
            "telephone_number": "215-235-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCSURDY",
        "first_name": "GRANT",
        "middle_name": "CARLOS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Leigh McSherry, MD
• Maryann Bidi McSorely, MD
• Kathleen McSorley, CRNP
• Kelly P McSpedon, MS, MA, CAADC
• Ryan William McSpedon, CRNP
• Kaitlyn Elizabeth McSurdy, MD
• Jacqueline June McSween, MSW, LCSW
• Andrea Joyce McSweeney, MD
• James McSweeney
• Robert McSweeney, MD

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.