Alim Jamal Grant, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN012743 Issued in GA

Practice address

1610 Ridenour Blvd NW Ste 102
Kennesaw, GA 30152-4486

Phone

(678) 273-2819

Fax

(678) 245-7162

NPI assigned

Feb 21, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

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

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.

• Newtown Family Dental PC

  • Dentist
  • Johns Creek, GA
  • NPI 1922533868
  NPD (past) Authorized official
• Sage Dental Group of Georgia, LLC

  • Dentist
  • Kennesaw, GA
  • NPI 1083309850
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1710012943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 RIDENOUR BLVD NW STE 102",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524486",
            "telephone_number": "678-273-2819",
            "fax_number": "678-245-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 RIDENOUR BLVD NW STE 102",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524486",
            "telephone_number": "678-273-2819",
            "fax_number": "678-245-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "ALIM",
        "middle_name": "JAMAL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012743",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "904873006B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INSURANC",
            "identifier": "1487913",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lane Gormley, LPC
• Anna Harrell Gould
• Ellen Rebecca Grade
• Yolanda Patrice Graham, M.D.
• Julie Renee Graiser, NP-C
• Erica Michelle Grant, LCSW
• Xavier Granville
• Mary Elizabeth Graves, PNP
• Michael Gray
• Zachary Paul Graziosi, RBT

• General Practice Dentistry in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.