Individual provider Active NPI

Frank C Grammer, DDS, PHD

  • Oral and Maxillofacial Surgery (Dentist)
  • Fayetteville, AR
National Provider Identifier
1376691097
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
1931 Issued in AR
Practice address
1708 E Joyce Blvd
Suite 2
Fayetteville, AR 72703-5252
Phone
(479) 582-3002
Fax
(479) 582-2840
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1931 AR Primary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 1931 AR

Addresses

Primary practice location

1708 E Joyce Blvd
Suite 2
Fayetteville, AR 72703-5252

Mailing address

PO Box 4185
Fayetteville, AR 72702-4185
Phone (479) 717-1171

Other identifiers 3

IdentifierTypeStateIssuer
58229OtherARBCBS
194717OtherUNITED CONCORDIA
234282400OtherARDEPT OF LABOR WORKERS COM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Oral & Facial Surgery Center PA Oral and Maxillofacial Surgery PastSince Jan 2, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1376691097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4185",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727024185",
            "telephone_number": "479-717-1171",
            "fax_number": "479-725-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 E JOYCE BLVD",
            "address_2": "SUITE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035252",
            "telephone_number": "479-582-3002",
            "fax_number": "479-582-2840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMMER",
        "first_name": "FRANK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AR",
            "license": "1931",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AR",
            "license": "1931",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "58229",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "194717",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR WORKERS COM",
            "identifier": "234282400",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.