Grady Randall PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN00201849 Issued in CO

Legal business name

GRADY RANDALL PLLC

Practice address

13764 E Quincy Ave
Aurora, CO 80015

Phone

(303) 690-0877

Fax

(303) 690-1250

NPI assigned

Mar 26, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Grady Randall

Title

Owner

Phone

(303) 690-0877

Specialties & licenses 1

Addresses

Other names 1

• Park Place Dental Doing business as

Locations

Practitioners 1

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

• Kenneth Robert Wilson, DDS

  • Dentist
  • Aurora, CO
  • NPI 1508873373
  NPD (past)

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1649512849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13764 E QUINCY AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80015",
            "telephone_number": "303-690-0877",
            "fax_number": "303-690-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13764 E QUINCY AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "80015",
            "telephone_number": "303-690-0877",
            "fax_number": "303-690-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRADY RANDALL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "GRADY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-690-0877",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN00201849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Place Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Graceful Ride LLC
• Damaris A. Gracia, LPC
• Sara Gracie, CGC
• Debra Gradick, M.D.
• Lizbeth Grado Gutierrez, MD
• Suzanne Dixon Grady, CNM, RN
• Lyndsey Christine Monfort Grae, MD
• David Graebe
• Calvin R. Graef III, O.D.
• Leonard Owen Graf, O.D.

• General Practice Dentistry in Aurora, CO
• Providers in Aurora, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.