Kristine Lazar Grace, DDS, MS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE00008652 Issued in WA

Practice address

11201 88TH Ave E
#110
Puyallup, WA 98373-3802

Phone

(253) 445-0022

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Guillermo E Chacon, DDS, PS

  • Oral and Maxillofacial Surgery (Dentist)
  • Puyallup, WA
  • NPI 1942820626
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407978281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 88TH AVE E",
            "address_2": "#110",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733802",
            "telephone_number": "253-445-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 88TH AVE E",
            "address_2": "#110",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733802",
            "telephone_number": "253-445-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "KRISTINE",
        "middle_name": "LAZAR",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00008652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Wendell Gorham, OD
• Joseph M Gossler, D.D.S.
• Tiffany Gota
• Nida Goulding, O.D.
• Sile Acacia Grace Matsui, MSW
• Graceful Living Home Health Care LLC
• Meredith Graham Lawrer, M.P.T.
• James W. Graham
• Jessica Graham, LMT
• Martin Laren Graham, MD

• Oral and Maxillofacial Surgery (Dentist) in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.