Active NPI
Zachary Adam Graham, DDS
- General Practice Dentistry
- West Des Moines, IA
National Provider Identifier
1639208093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 08507
- Practice address
- 9350 University Ave
Suite 128
West Des Moines, IA 50266 - Phone
- (515) 987-0680
- Fax
- (515) 987-0256
- NPI assigned
- Mar 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 08507 | IA | Primary |
| General Practice Dentistry | 1223G0001X | 5484-015 | WI |
Addresses
Primary practice location
9350 University Ave
Suite 128
West Des Moines, IA 50266
Mailing address
9350 University Ave
Suite 128
West Des Moines, IA 50266
Phone (515) 987-0680
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08507 | IA | MD | General Practice Dentistry |
| 5484-015 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graham Family Dentistry, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- West Des Moines, IA
- NPI 1073780490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193961600000",
"number": "1639208093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9350 UNIVERSITY AVE",
"address_2": "SUITE 128",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "50266",
"telephone_number": "515-987-0680",
"fax_number": "515-987-0256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9350 UNIVERSITY AVE",
"address_2": "SUITE 128",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "50266",
"telephone_number": "515-987-0680",
"fax_number": "515-987-0256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "ZACHARY",
"middle_name": "ADAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-03",
"last_updated": "2007-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IA",
"license": "08507",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "5484-015",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.