Milton Joseph Grisham Jr., D.O

Primary specialty

DentistTaxonomy code 122300000X

License

51683 Issued in CA

Practice address

2841 Rendova Road
San Diego, CA 92155-5490

Phone

(619) 437-2117

Fax

(619) 437-2700

NPI assigned

Jan 11, 2006

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 TX

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

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457481600000",
    "number": "1386623171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11823 MERIDEN LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284335",
            "telephone_number": "858-208-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 RENDOVA ROAD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555490",
            "telephone_number": "619-437-2117",
            "fax_number": "619-437-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "MILTON",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2016-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Grisafi
• Jeanie C Grischy, CRNA
• Audrey Kaitlyn Grisco
• Cristina Aranda Grisham, M.A.
• Michael Grisham
• Lauren Grismer, PT, DPT
• Charletha Grisolia
• James Santiago Grisolia, M.D.INC
• Amy Elizabeth Grissinger, NURSE PRACTITIONER
• Kathryn Anderson Griver, RD,CDE

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.