Individual provider Active NPI

William Jefferson Graves, DMD

  • Dentist
  • Midfield, AL
National Provider Identifier
1740355676
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
3419 Issued in AL
Practice address
114 E Brookwood Road
Midfield, AL 35228
Phone
(205) 923-6828
Fax
(205) 923-1680
NPI assigned
Nov 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 3419 AL Primary

Addresses

Primary practice location

114 E Brookwood Road
Midfield, AL 35228

Mailing address

4334 Marden Dr
Birmingham, AL 35242-2212
Phone (205) 923-6828

Other identifiers 1

IdentifierTypeStateIssuer
51091626GRAOtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170316000534 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214212158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3419ALMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Midfield Dental Center Associates Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740355676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4334 MARDEN DR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422212",
            "telephone_number": "205-923-6828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E BROOKWOOD ROAD",
            "city": "MIDFIELD",
            "state": "AL",
            "postal_code": "35228",
            "telephone_number": "205-923-6828",
            "fax_number": "205-923-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "WILLIAM",
        "middle_name": "JEFFERSON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "3419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51091626GRA",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midfield, AL

Sources for this page

Verify at the official NPI Registry.