Larry Lloyd Graham, D.D.S

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12006195A Issued in IN

Practice address

1050 Wishard Blvd
RM. 4201
Indianapolis, IN 46202-2872

Phone

(317) 274-5315

NPI assigned

Sep 24, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Indiana University

  dba Indiana University School of Dentistry

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1689790552

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669572178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 WISHARD BLVD",
            "address_2": "RM. 4201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-274-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 WISHARD BLVD",
            "address_2": "RM. 4201",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022872",
            "telephone_number": "317-274-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LARRY",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12006195A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imani Graham, DPM
• Jessica Anne Graham, PSY.D.
• Jiya L Graham
• Joshua Steven Graham
• Kirsten P Graham, DT
• Michael Q. Graham, M.D.
• Nicole Leann Graham
• Samantha M Graham, NP
• Shana P Graham, CERTIFIED NURSING AI
• Stephanie Graham, LCSW

• Oral and Maxillofacial Surgery (Dentist) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.