Active NPI
Vincent Mark Graves, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Mansfield, TX
National Provider Identifier
1730818469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 38114
- Practice address
- 1681 E Broad St Ste 107
Mansfield, TX 76063-4347 - Phone
- (682) 300-2300
- NPI assigned
- Jun 8, 2022
- Last updated
- Jun 8, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 38114 | TX | Primary |
Addresses
Primary practice location
1681 E Broad St Ste 107
Mansfield, TX 76063-4347
Mailing address
2970 Brandywine Rd Ste 200
Atlanta, GA 30341-5549
Phone (843) 990-5186
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 |
|---|---|---|---|
| 38114 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654646400000",
"number": "1730818469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 BRANDYWINE RD STE 200",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303415549",
"telephone_number": "843-990-5186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1681 E BROAD ST STE 107",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760634347",
"telephone_number": "682-300-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "VINCENT",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-06-08",
"last_updated": "2022-06-08",
"certification_date": "2022-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "38114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
- Shelby Grabeal, RPH
- Lezirel Gracia, PT, DPT
- Keely Nicole Grant-Mirle, DNP, APRN, FNP-BC
- Joan Grant, RN, BSN, CCM
- Nicole Reyes Grant, DMD
- Deshawndranique D Gray, M.D.
- Great Expressions Dental Centers of Texas, PLLC (Great Expressions Dental Centers)
- Great Faith Senior Care Services
- Greater Houston Emergency Physicians, PLLC
- Green Oaks Physical Therapy Limited Partnership (Green Oaks Physical Therapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.