Justin Lamar Grimes, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN014646 Issued in GA

Practice address

15 Ruth Dr
Newnan, GA 30265-2317

Phone

(770) 253-3171

NPI assigned

Aug 1, 2013

Sex

Male

Sole proprietor

No

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)

Not 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.

• Coweta Dentistry Sda PC

  • General Practice Dentistry
  • Newnan, GA
  • NPI 1689118127
  NPD (past)

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1689006603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "762-408-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 RUTH DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652317",
            "telephone_number": "770-253-3171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 Van Aalst Blvd",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "GA",
            "postal_code": "319052102",
            "country_code": "US",
            "telephone_number": "762-408-3086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIMES",
        "first_name": "JUSTIN",
        "middle_name": "LAMAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-01",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN014646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Griffin
• Carolyn Tyler Griffin
• Christan Michele Griffin, NP
• John Stephen Griffin, RPH
• Brandon Lebron Griggs, NP
• Sean Grisham
• Ora Charita Lewis Griskell, MS, RDN, LD
• Kevin Groover
• Michael P. Gruber, MD
• Guiding Light Hospice SW, LLC

• Oral and Maxillofacial Surgery (Dentist) in Newnan, GA
• Providers in Newnan, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.