Bernard L. Gradoville, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7250 Issued in IA

Practice address

2800 Ingersoll Ave
Des Moines, IA 50312-4013

Phone

(515) 243-2412

Fax

(515) 243-1248

NPI assigned

Nov 8, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Ingersoll Family Dentistry

  • General Practice Dentistry
  • Des Moines, IA
  • NPI 1538828678
  NPD Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619958600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124013",
            "telephone_number": "515-243-2412",
            "fax_number": "515-243-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503124013",
            "telephone_number": "515-243-2412",
            "fax_number": "515-243-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADOVILLE",
        "first_name": "BERNARD",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048066",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace, Inc
• Grace, Inc
• Grace, Inc
• Safiyah S Grace
• Gracious Growth Iowa LLC
• Kathleen Gradoville, ARNP
• Wendy K. Gradwell, NNP
• Herman Henry Graefe, MD
• Janet Graeve, MD
• Tawnie Graff, DO

• General Practice Dentistry in Des Moines, IA
• Providers in Des Moines, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.