Jae Marie Grymes, DDS

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

G1-0001460 Issued in DE

Practice address

1290 Peoples PLZ
Newark, DE 19702-5701

Phone

(302) 273-0247

NPI assigned

Jul 8, 2013

Last updated

Aug 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 8, 2021 through Feb 8, 2027

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.

• Chesapeake Pediatric Dental Group, Inc

  • Pediatric Dentistry
  • Perry Hall, MD
  • NPI 1093589350
  NPD (past)
• CPDG-Am

  • Pediatric Dentistry
  • Hanover, MD
  • NPI 1891043006
  NPD (past)

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1528409448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 PEOPLES PLZ",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 PEOPLES PLZ",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025701",
            "telephone_number": "302-273-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYMES",
        "first_name": "JAE MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "16241",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "DE",
            "license": "G1-0001460",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "MD",
            "license": "16241",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "DE",
            "license": "G1-0001460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanne Callan Grove, PA-C
• David Schuler Grubbs, M.D.
• Stephen S Grubbs, MD
• Jennifer Grugan, PA-C
• Ruth S Grulich, LCSW
• Guardian Angel Home Health Care Agency, LLC
• Melissa Hoffman Guarino, PA-C
• Julie B Guarneri, P.T.
• Justin B Guerin, PA-C
• Kenneth Guerino

• Dental Anesthesiology in Newark, DE
• Providers in Newark, DE by specialty
• Dental Anesthesiology in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.