Michael Lillis Grimes, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS-019035-L Issued in PA

Practice address

2550 Mosside Blvd
Suite 213
Monroeville, PA 15146-3540

Phone

(412) 856-8002

NPI assigned

Nov 1, 2005

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1306837158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 MOSSIDE BLVD",
            "address_2": "SUITE 213",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463540",
            "telephone_number": "412-856-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MOSSIDE BLVD",
            "address_2": "SUITE 213",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151463540",
            "telephone_number": "412-856-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "MICHAEL",
        "middle_name": "LILLIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-01",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS-019035-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas J Gresock, D.C.
• Katelyn Gress, OTR/L
• Rachel Kaitlyn Gribbin, PHARMD
• Emily Griffin, MA, LAPC, ATR-P
• Rikki Lynn Griffin, MS
• Brittany Grinnell, MS, LPC
• Lisa Ann Gross
• Madison Grossman, DO
• Olivia June Grubschmidt, RDN
• Virginia L. Guastaferro, OTR/L

• Pediatric Dentistry in Monroeville, PA
• Providers in Monroeville, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; 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.