Justin Thomas Graham, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN27000 Issued in FL

Practice address

2242 Ashley Oaks Cir
Wesley Chapel, FL 33544-6404

Phone

(813) 991-5300

NPI assigned

Jun 9, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Francisco H Bezerra DDS PA

  • Pediatric Dentistry
  • Land O Lakes, FL
  • NPI 1619545944
  NPD

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1336878693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 ASHLEY OAKS CIR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446404",
            "telephone_number": "813-991-5300",
            "fax_number": "888-520-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 ASHLEY OAKS CIR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446404",
            "telephone_number": "813-991-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6935 Land O Lakes Blvd",
            "address_purpose": "LOCATION",
            "city": "Land O Lakes",
            "state": "FL",
            "postal_code": "346383231",
            "country_code": "US",
            "telephone_number": "813-530-3300",
            "fax_number": "855-820-1235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1180 Ponce De Leon Blvd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337561014",
            "country_code": "US",
            "telephone_number": "727-310-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JUSTIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-09",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN27000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121860900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Adela Gotcher, APRN, FNP-BC
• Tanika A Goulbourne
• Graceful Caring
• Graceful Nurses, LLC
• Jessica Marie Graham, LMHC
• Richard Anthony Graham
• Aneesa Grant-Hutchinson
• Jasmine Graves, PMHNP-BC
• Ethel Gray, CNA
• Greater Florida Anesthesiologists, LLC

• Pediatric Dentistry in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.