Robert Thomas Gramins, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

54377 Issued in CA

Practice address

12630 Monte Vista Rd Ste 205
Poway, CA 92064-2527

Phone

(858) 485-1290

Fax

(858) 675-7485

NPI assigned

Nov 1, 2006

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 16, 2017 through Feb 16, 2027

Medicare enrollment (NPD)

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.

• Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Oak Lawn, IL
  • NPI 1669480851
  NPD (past)
• Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Tinley Park, IL
  • NPI 1801804182
  NPD (past)
• Midland Oral Surgery and Implant Centers, LTD

  • Oral and Maxillofacial Surgery (Dentist)
  • Western Springs, IL
  • NPI 1992541635
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285711291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD STE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642527",
            "telephone_number": "858-485-1290",
            "fax_number": "858-675-7485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 MONTE VISTA RD STE 205",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642527",
            "telephone_number": "858-485-1290",
            "fax_number": "858-675-7485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMINS",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "54377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen H. Gould, MD
• Cassondra Pamela Graff, LCSW
• De'Jha Graham
• Savion Graham
• Stuart Nathan Graham, MD
• Robert Morris Gray, PH.D.
• Jennifer L Green
• Jesse Green
• Nella Green, M.D.
• Savanah Greeson

• Oral and Maxillofacial Surgery (Dentist) in Poway, CA
• Providers in Poway, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.