Joseph Wayne Grimsley, DMD
Individual provider Active NPI General Practice Dentistry · Colquitt, GA
NPI 1275565889 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1275565889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DN010031 (GA)
- Practice address
- 115 N Cuthbert St
Colquitt, GA 39837-3401 - Phone
- (229) 758-3345
- Fax
- (229) 758-3339
- NPI assigned
- Jul 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN010031 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grimsley Dental Clinic, LLC | Past | Accepting new patients | |
| Colquitt Dental Care,LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN010031 | GA | Yes |
Addresses
Primary practice location
115 N Cuthbert St
Colquitt, GA 39837-3401
Mailing address
115 N Cuthbert St
P.O. Box 96
Colquitt, GA 39837-3401
Phone (229) 758-3345
Other providers in Colquitt, GA
- Brandy Smith Floyd
- Four C, LLC
- Ivanshi A Gondalia
- Wendy Page Grimes
- Grimsley Dental Clinic, LLC
- Markesha Leshea Groomes
- Patty Hall
- Brittany N. Harrison
- Kelsey Rice Holt
- Hope Cottage Family Healthcare, LLC
All providers in Colquitt, GA · General Practice Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.