Bryan Douglas Graham, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

8371 Issued in NC

Practice address

221 13TH Avenue PL NW
Suite 102
Hickory, NC 28601-2596

Phone

(828) 328-5581

Fax

(828) 322-1745

NPI assigned

May 18, 2007

Sex

Male

Sole proprietor

No

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

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

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 and National Provider Directory roles.

• Bryan Graham and Kyle McKinney DDS

  • Dentist
  • Hickory, NC
  • NPI 1356038608
  NPD (past) Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1780892133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 13TH AVENUE PL NW",
            "address_2": "SUITE 102",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012596",
            "telephone_number": "828-328-5581",
            "fax_number": "828-322-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 13TH AVENUE PL NW",
            "address_2": "SUITE 102",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286012596",
            "telephone_number": "828-328-5581",
            "fax_number": "828-322-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BRYAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "8371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Amber Goudas, NP
• Courtney Anne Gouge, PA-C
• Virginia C Gouger, HIS
• Gragg Hickory PLLC
• Graham and McKinney PLLC
• Brooke Marie Graniello
• Ayana Cierra Grant
• Emily Anne Grant, BSW
• Taylor Ramsey Grant, DNP, FNP
• Gray Chiropractic of Hickory PLLC

• Dentist in Hickory, NC
• Providers in Hickory, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.