Kelly Granger, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

17330 Issued in MD

Practice address

80 E Jefferson St Ste 400B
Falls Church, VA 22046-3569

Phone

(703) 241-5437

NPI assigned

Jul 12, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Little Smiles of Northern Virginia PLLC

  • Dental Clinic/Center
  • Falls Church, VA
  • NPI 1376969386
  NPD (past)
• Frederick Kidds Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Frederick, MD
  • NPI 1043694623
  NPD (past)

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1497489744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 M ST NW APT 520",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200054222",
            "telephone_number": "516-729-9830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 E JEFFERSON ST STE 400B",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463569",
            "telephone_number": "703-241-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Shorebird St Ste B",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217011963",
            "country_code": "US",
            "telephone_number": "301-202-5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DC",
            "license": "DEN2000111",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "17330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@frederickkidds.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "211 Shorebird St Ste B",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217011963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Marie Nicolaisen Graham, MSW
• Charles M Graham Jr., SA
• Jennifer Graham, R.N.
• Virginia L Graham, LPC
• Marc D. Grande, PSY.D.
• Alexandria Stevie Grant-Presser, BCBA, LBA
• Monique Aida Grant, PT
• Brinda Grapin
• Kathryn W Grassmeyer, PT, DPT
• Hannah M Grausz, MD

• Pediatric Dentistry in Falls Church, VA
• Providers in Falls Church, VA by specialty
• Pediatric Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.