Kevin C. Granger, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

0401411967 Issued in VA

Practice address

2415 Benning Rd NE
Washington, DC 20002-4827

Phone

(202) 396-9679

Fax

(202) 396-9773

NPI assigned

Dec 22, 2005

Last updated

Jun 29, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

• Enterprise Dental Care

  • Dental Clinic/Center
  • Mitchelleville, MD
  • NPI 1992207476
  NPD Authorized official
• Smile Services, LLC

  • Public Health Dentistry
  • Washington, DC
  • NPI 1366797748
  NPD (past) Authorized official
• KC Granger DDS PC

  • General Practice Dentistry
  • Mitchelleville, MD
  • NPI 1982914305
  Authorized official Same address or phone
• Kevin C. Granger, D.D.S., P.C.

  • Dentist
  • McLean, VA
  • NPI 1649418377
  NPD (past) Authorized official
• Dr. Heyward Burrell Dental Practice, PC

  • General Practice Dentistry
  • Washington, DC
  • NPI 1487950929
  NPD (past)
• Smile Services DC PLLC

  • General Practice Dentistry
  • Washington, DC
  • NPI 1922499730
  NPD (past)

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1467439281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8363B GREENSBORO DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023530",
            "telephone_number": "615-480-5562",
            "fax_number": "703-556-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 BENNING RD NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200024827",
            "telephone_number": "202-396-9679",
            "fax_number": "202-396-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "KEVIN",
        "middle_name": "C.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "T22045",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "14112",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170550101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049045800",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039607900",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051370400",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hilary Granat, PT
• Hope Grande
• Laura Marie Grande, MS, RD, LD
• Theresa Boykin Graneau
• Alexandra Granger
• Barbara Grant Boneta, MA
• Grant Park Nursing Home Limited Partnership (Grant Park Care Center)
• Grant Park SNF, LLC (Deanwood Rehabilitation and Wellness Center)
• Rashawn Grant-Adona
• Donna Belinda Grant-Mills, DDS

• Dentist in Washington, DC
• Providers in Washington, DC by specialty
• Dentist in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.