Individual provider Active NPI

Grant Laham, DMD

  • General Practice Dentistry
  • Overland Park, KS
National Provider Identifier
1235650003
Registry record updated Aug 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61438 Issued in KS
Practice address
10351 Mastin St
Overland Park, KS 66212
Phone
(316) 209-0474
NPI assigned
Jul 3, 2017
Last updated
Aug 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61438 KS Primary

Addresses

Primary practice location

10351 Mastin St
Overland Park, KS 66212

Mailing address

9911 E 21St St N Apt 412
Wichita, KS 67206-3525
Phone (316) 209-0474

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

LicenseStateTypeSpecialty
61438KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kansas Family Dental, LLC General Practice Current Accepting new patients
Grant Laham, DMD, LLC General Practice CurrentSince Jun 12, 2022 Accepting new patients
Cambridge Family Dentisty PA General Practice Past Accepting new patients
Cambridge Family Dentistry, P.a. Past Accepting new patients

Locations

10351 Mastin St
Overland Park, KS 66212
Phone (316) 209-0474

4160 Heritage Trace Pkwy
Ste 408
Fort Worth, TX 76244
Phone (817) 741-4288

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661472000000",
    "number": "1235650003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9911 E 21ST ST N APT 412",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063525",
            "telephone_number": "316-209-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10351 MASTIN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66212",
            "telephone_number": "316-209-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHAM",
        "first_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-08-26",
        "certification_date": "2022-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; 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.