Virginia Nocilla Grimball, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5477 Issued in LA

Practice address

1570 Maplewood Dr
Sulphur, LA 70663-5643

Phone

(337) 625-2212

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Roger Glen Grimball Jr. D.D.S. LLC

  dba Grimball Pediatric Dentistry

  • Pediatric Dentistry
  • Sulphur, LA
  • NPI 1821662297
  NPD

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1740874825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 MAPLEWOOD DR",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706635643",
            "telephone_number": "337-625-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 MAPLEWOOD DR",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706635643",
            "telephone_number": "337-625-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMBALL",
        "first_name": "VIRGINIA",
        "middle_name": "NOCILLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krysta Gould
• Jadah Granger, APRN
• Grimball & Richert Clinic
• Roger G Grimball, MD
• Roger Glen Grimball Jr., D.D.S.
• Brett Gschwend, D.C.
• Jackie Lynn Guidry, NP
• Kevin Michale Guilbeaux, PT
• Steven Paul Guillory, RPH
• Marissa Hall

• General Practice Dentistry in Sulphur, LA
• Providers in Sulphur, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.