Active NPI
Kenneth Gray, DDS
- Dentist
- Granbury, TX
National Provider Identifier
1639623176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 32274
- Practice address
- 301 E Hwy 377 Ste 100
Granbury, TX 76048-1201 - Phone
- (817) 776-4337
- NPI assigned
- Aug 13, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 32274 | TX | Primary |
Addresses
Primary practice location
301 E Hwy 377 Ste 100
Granbury, TX 76048-1201
Mailing address
301 E Hwy 377 Ste 100
Granbury, TX 76048-1201
Phone (817) 776-4337
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 |
|---|---|---|---|
| 32274 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471046400000",
"number": "1639623176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 E HWY 377 STE 100",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760481201",
"telephone_number": "817-776-4337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E HWY 377 STE 100",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760481201",
"telephone_number": "817-776-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "KENNETH",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-13",
"last_updated": "2016-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "32274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granbury, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.