Active NPI
Robert David Grady, DDS
- Prosthodontics
- Minneapolis, MN
National Provider Identifier
1235298035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- D10844
- Practice address
- 515 Delaware St SE
9-470C Moos Tower
Minneapolis, MN 55455-0357 - Phone
- (612) 626-5161
- Fax
- (612) 626-1496
- NPI assigned
- Dec 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | D10844 | MN | Primary |
Addresses
Primary practice location
515 Delaware St SE
9-470C Moos Tower
Minneapolis, MN 55455-0357
Mailing address
240 Spring St
#410
Saint Paul, MN 55102-4477
Phone (651) 353-6765
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D10844 | MN | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430438400000",
"number": "1235298035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 SPRING ST",
"address_2": "#410",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551024477",
"telephone_number": "651-353-6765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 DELAWARE ST SE",
"address_2": "9-470C MOOS TOWER",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554550357",
"telephone_number": "612-626-5161",
"fax_number": "612-626-1496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "ROBERT",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-07",
"last_updated": "2015-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MN",
"license": "D10844",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.