Eric Lee Grant, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D012079 Issued in AZ

Practice address

2915 E Baseline Rd Ste 106
Gilbert, AZ 85234-2427

Phone

(480) 539-6420

NPI assigned

Mar 27, 2020

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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.

• Desert Valley Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Gilbert, AZ
  • NPI 1881189199
  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1356979322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 E BASELINE RD STE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 E BASELINE RD STE 106",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342427",
            "telephone_number": "480-539-6420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21321 E Ocotillo Rd Ste 117",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851425994",
            "country_code": "US",
            "telephone_number": "480-655-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ERIC",
        "middle_name": "LEE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "D012079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katlyn Ann Grams
• Grand Canyon Diagnostic Services
• Grand Canyon State Health Care LLC
• Deepa Maria Grandon, M.D., M.B.A
• Emalee Grant, LPC
• Isabel Grant, ND
• Scott C Grant, MD
• Titilayo Grant, FNP
• Alissa Daniella Graves
• Aaliyah Gray

• Oral and Maxillofacial Surgery (Dentist) in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Oral and Maxillofacial Surgery (Dentist) in Arizona

• 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.
• 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.