Individual provider Active NPI

Caroline Elise Grand, DDS

  • Dentist
  • Baton Rouge, LA
National Provider Identifier
1720658693
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7253 Issued in LA
Practice address
5188 Highland Rd
Baton Rouge, LA 70808-6527
Phone
(225) 766-8107
NPI assigned
Jul 1, 2021
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7253 LA Primary

Addresses

Primary practice location

5188 Highland Rd
Baton Rouge, LA 70808-6527

Mailing address

612 Dubois Dr
Baton Rouge, LA 70808-5007
Phone (225) 802-5693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20230509000146 LA Order and Referring Only - DentistPractitioner - Dentist 6204291677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7253LAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1720658693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 DUBOIS DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708085007",
            "telephone_number": "225-802-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5188 HIGHLAND RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708086527",
            "telephone_number": "225-766-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAND",
        "first_name": "CAROLINE",
        "middle_name": "ELISE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.