Tabbitha Grantham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401411441 Issued in VA

Practice address

1122 N 25TH St
Suite E
Richmond, VA 23223-5254

Phone

(804) 649-0240

Fax

(804) 643-4733

NPI assigned

Oct 12, 2006

Last updated

Sep 19, 2012By the provider in NPPES

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 VA

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

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348012800000",
    "number": "1649369919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 EDGEWOOD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232222508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 N 25TH ST",
            "address_2": "SUITE E",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232235254",
            "telephone_number": "804-649-0240",
            "fax_number": "804-643-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "TABBITHA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Grant
• Jeffrey Daniel Grant, PA-C
• Olivia Elaine Grant, PSY.D.
• Steven Grant, M.D.
• Tracy L Grant, LPC
• Jordan Allen Grantz, COTA/L
• Danielle B Granville, LPC
• Stephen Grasberger, LCSW
• Mario P Grasso II, CRNA
• Jason Michael Graus, ATC

• General Practice Dentistry in Richmond, VA
• Providers in Richmond, 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 Sep 19, 2012; 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.