Lisa Renee Grimes, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10214 Issued in KY

Practice address

1204 W Willow Rd
Ste. C
Enid, OK 73703-2531

Phone

(580) 233-1427

Fax

(580) 233-1423

NPI assigned

Jan 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1306998893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 INDIAN DR",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737036711",
            "telephone_number": "580-242-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 W WILLOW RD",
            "address_2": "STE. C",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737032531",
            "telephone_number": "580-233-1427",
            "fax_number": "580-233-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "LISA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "5575",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "10214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100043850A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory D. Thomas, D.D.S., P.C.
• Kurt Grieshober, DDS
• Danesa Griffin
• Shereen Griffin
• Talisha Griffin
• Jennifer S Grittman
• Michael R Grossman, MD
• Charles Raymond Kondo Grothe, DDS
• Cody Wayne Groves, MS, LPC CANDIDATE
• Sharon Groves

• General Practice Dentistry in Enid, OK
• Providers in Enid, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.