Marcos A Grande, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401411982 Issued in VA

Practice address

108 Elden St Ste 10
Herndon, VA 20170-4886

Phone

(703) 471-7164

Fax

(703) 471-1801

NPI assigned

Jun 1, 2007

Last updated

Feb 20, 2018By 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 1

Addresses

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

• Marcos Grande DDS PLLC

  dba Express Smiles

  • General Practice Dentistry
  • Herndon, VA
  • NPI 1326462367
  NPD (past) Authorized official

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1578765723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 ELDEN ST STE 10",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704886",
            "telephone_number": "703-471-7164",
            "fax_number": "703-471-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 ELDEN ST STE 10",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704886",
            "telephone_number": "703-471-7164",
            "fax_number": "703-471-1801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1611 NW 12th Ave",
            "address_2": "Jackson Memorial Hospital ACC EAST 2nd floor",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361005",
            "country_code": "US",
            "telephone_number": "305-585-5326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANDE",
        "first_name": "MARCOS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Goss, MS, CCC-SLP
• George Gotsiridze, DMD
• Nour Gowharji, BDS,DMD
• Gracewell Inc
• Brenda Graciano
• Laura Grandy, MSW
• Colin Nicholas Grant, O.D,
• Gravity Spine LLC (Gravity Spine and Wellness)
• Cameron Gray
• Jennifer Graydon

• General Practice Dentistry in Herndon, VA
• Providers in Herndon, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; 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.