Individual provider Active NPI

Michael Allen Granet, D.D.S.

  • Periodontics
  • Cumberland, MD
National Provider Identifier
1760492797
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
6686 Issued in MD
Practice address
57 Greene St
Cumberland, MD 21502-2926
Phone
(301) 759-1212
Fax
(301) 777-1680
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

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
Periodontics 1223P0300X 6686 MD Primary

Addresses

Primary practice location

57 Greene St
Cumberland, MD 21502-2926

Mailing address

57 Greene St
Cumberland, MD 21502-2926
Phone (301) 759-1212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20230208001204 NC Practitioner - Dentist 0648595231 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12443NCMDMental Health Counselor
6686MDMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Dec 1, 2022 Accepting new patients
East Carolina University Current Accepting new patients
East Carolina University CurrentSince Dec 1, 2022 Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 3

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760492797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 GREENE ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022926",
            "telephone_number": "301-759-1212",
            "fax_number": "301-777-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 GREENE ST",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022926",
            "telephone_number": "301-759-1212",
            "fax_number": "301-777-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANET",
        "first_name": "MICHAEL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "6686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.