Barbara Anne Graham, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11412 Issued in CT

Practice address

738 Wolcott St
Waterbury, CT 06705-1336

Phone

(203) 437-6213

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in CT

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

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.

• Staywell Health Care, Inc.

  • Family Medicine Physician
  • Waterbury, CT
  • NPI 1154342335
  Medicare reassignment NPD

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1639550577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051336",
            "telephone_number": "203-437-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 WOLCOTT ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067051336",
            "telephone_number": "203-437-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BARBARA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denesha Gordon
• Michelle Renee Gotay
• Victor M Gotay, MD
• Bruce Seth Gottlieb, DDS
• Helena Grabo, M.D.
• Doreen Ann Graham, APRN
• Michael Graham Sr., LCSW
• Kristen Granatek, MS,BA
• Michael John Granieri, D.O.
• Nickeshia Grant

• General Practice Dentistry in Waterbury, CT
• Providers in Waterbury, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.