Mary Kathleen Grady, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10810 Issued in OR

Practice address

200 SW 7TH St
Redmond, OR 97756-2112

Phone

(541) 548-4064

NPI assigned

Mar 3, 2017

Last updated

Apr 15, 2020By the provider in NPPES

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)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jed D. Keener DDS LLC

  • General Practice Dentistry
  • Redmond, OR
  • NPI 1407406879
  NPD
• Mark S Keener DMD P.C.

  • General Practice Dentistry
  • Redmond, OR
  • NPI 1760748602
  NPD (past)
• Taylor C. Fowles, DMD, LLC

  dba East Bend Dental

  • General Practice Dentistry
  • Bend, OR
  • NPI 1518233667
  NPD (past)

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586908800000",
    "number": "1447790837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1184 SW SILVER LAKE BLVD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977022194",
            "telephone_number": "708-307-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SW 7TH ST",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977562112",
            "telephone_number": "541-548-4064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 N Cook St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992075879",
            "country_code": "US",
            "telephone_number": "509-326-4382",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2250 NE Professional Ct",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977016063",
            "country_code": "US",
            "telephone_number": "541-388-1434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRADY",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodwin Counseling & Wellness LLC
• Kelly Ross Goodwin
• Melissa Goray
• Ryan Robert Gorman
• Lori Ann Gorton
• Courtney Graham, LCSW
• Deborah Grant, LMT
• Pamela Ann Graves-Gebhardt
• Maryann Gray, BA
• Amanda Graybill, MS CCC SLP

• General Practice Dentistry in Redmond, OR
• Providers in Redmond, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.