Gary Lee Grimm Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00010829 Issued in WA

Practice address

2727 Hollycroft St
Suite #470, West Building
Gig Harbor, WA 98335-1305

Phone

(253) 858-7717

Fax

(253) 858-7605

NPI assigned

May 9, 2007

Last updated

Jun 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Gary L Grimm DDS PLLC

  dba Innovative Smiles

  • Dentist
  • Gig Harbor, WA
  • NPI 1255279220
  NPD Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1548474869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 HOLLYCROFT ST",
            "address_2": "SUITE #470, WEST BUILDING",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351305",
            "telephone_number": "253-858-7717",
            "fax_number": "253-858-7605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 HOLLYCROFT ST",
            "address_2": "SUITE #470, WEST BUILDING",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351305",
            "telephone_number": "253-858-7717",
            "fax_number": "253-858-7605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010829",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greta Reynolds Greer, LMP
• Michael Dwyer Grennan
• Irene Grias, D.O.
• Janice Grigar
• Gayle E Grimes, LMT
• Trevor Winston Grimm
• Paul Juris Grobins, LAC, EAMP
• Peyton Groft, PT, DPT
• Jenifer Groh, MA 60062993
• Jan Ellen Grouse, M.D.

• General Practice Dentistry in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.