NPIMap

Organization Active NPI

Kevin C. Granger, D.D.S., P.C.

  • Dentist
  • MC Lean, VA
National Provider Identifier
1649418377
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401411967 Issued in VA
Legal business name
KEVIN C. GRANGER, D.D.S., P.C.
Practice address
8363B Greensboro Dr
MC Lean, VA 22102-3530
Phone
(703) 790-5533
Fax
(703) 556-9760
NPI assigned
Feb 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin GrangerNPI 1467439281
Title
Owner
Phone
(703) 790-5533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 0401411967 VA Primary

Addresses

Primary practice location

8363B Greensboro Dr
MC Lean, VA 22102-3530

Mailing address

8363B Greensboro Dr
MC Lean, VA 22102-3530
Phone (703) 790-5533

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233619200000",
    "number": "1649418377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8363B GREENSBORO DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023530",
            "telephone_number": "703-790-5533",
            "fax_number": "703-556-9760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8363B GREENSBORO DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023530",
            "telephone_number": "703-790-5533",
            "fax_number": "703-556-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN C. GRANGER, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-03",
        "last_updated": "2009-02-03",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-790-5533",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401411967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in MC Lean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.