Marlia Sandra Granigan, DMD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

64 Moncrief Rd
Rockland, MA 02370-1528

Phone

(781) 974-8694

NPI assigned

May 30, 2019

Last updated

May 30, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1316505902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MONCRIEF RD",
            "city": "ROCKLAND",
            "state": "MA",
            "postal_code": "023701528",
            "telephone_number": "781-974-8694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MONCRIEF RD",
            "city": "ROCKLAND",
            "state": "MA",
            "postal_code": "023701528",
            "telephone_number": "781-974-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANIGAN",
        "first_name": "MARLIA",
        "middle_name": "SANDRA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMD",
            "identifier": "00000000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Rockland, MA
• Providers in Rockland, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.