Active NPI
Katherine A Grady, DDS
- Dentist
- Clermont, FL
National Provider Identifier
1730499476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN19211
- Practice address
- 875 Oakley Seaver Drive
Clermont, FL 34711 - Phone
- (352) 989-9001
- Fax
- (352) 360-6674
- NPI assigned
- Oct 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN19211 | FL | Primary |
Addresses
Primary practice location
875 Oakley Seaver Drive
Clermont, FL 34711
Mailing address
PO Box 1305
Tavares, FL 32778-1305
Phone (352) 589-6424
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN19211 | FL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Past | Accepting new patients | |
| Florida Department of Health | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health or Welfare Agency
- Bronson, FL
- NPI 1154395390
-
- Public Health or Welfare Agency
- Eustis, FL
- NPI 1679548861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1730499476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1305",
"city": "TAVARES",
"state": "FL",
"postal_code": "327781305",
"telephone_number": "352-589-6424",
"fax_number": "352-589-6492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 OAKLEY SEAVER DRIVE",
"city": "CLERMONT",
"state": "FL",
"postal_code": "34711",
"telephone_number": "352-989-9001",
"fax_number": "352-360-6674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRADY",
"first_name": "KATHERINE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN19211",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.