Megan Gray, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

1001011 Issued in WI

Practice address

6226 14TH Ave
Kenosha, WI 53143-4413

Phone

(262) 656-0044

Fax

(262) 764-3636

NPI assigned

May 22, 2009

Last updated

Nov 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Megan Dawson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Megan N Gray DDS LTD

  • Dental Clinic/Center
  • Gurnee, IL
  • NPI 1568027522
  NPD Authorized official

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1780819599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 57TH ST",
            "address_2": "SUITE 700",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404146",
            "telephone_number": "262-764-3622",
            "fax_number": "262-764-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 14TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531434413",
            "telephone_number": "262-656-0044",
            "fax_number": "262-764-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "MEGAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019027924",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "FD1476488",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780819599",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "DAWSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cheryl Graham
• Cassandra Grant
• Jerome Robert Gratz
• Brandy Michelle Graves
• Ebonie Gray, RN, APNP, FNP-BC
• Great Lakes Dermatology
• Great Lakes Family Medical Center Inc
• Great Lakes Foot & Ankle Centers Inc
• Great Lakes Neurosurgical Associates LLC
• Great Lakes Surgery Center LLC

• Dentist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; 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.