Active NPI
Kevin Scott Grimm, DDS
- Dentist
- Brighton, MI
National Provider Identifier
1811071384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901015657
- Practice address
- 8609 W Grand River Ave
Suite 201
Brighton, MI 48116-4398 - Phone
- (810) 225-0022
- Fax
- (810) 225-0033
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901015657 | MI | Primary |
Addresses
Primary practice location
8609 W Grand River Ave
Suite 201
Brighton, MI 48116-4398
Mailing address
8609 W Grand River Ave
Suite 201
Brighton, MI 48116-4398
Phone (810) 225-0022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161129002444 | MI | Order and Referring Only - Dentist | 4486934932 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901015657 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westwind Dental PLLC | 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.
-
- General Practice Dentistry
- Brighton, MI
- NPI 1336160605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213056000000",
"number": "1811071384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8609 W GRAND RIVER AVE",
"address_2": "SUITE 201",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481164398",
"telephone_number": "810-225-0022",
"fax_number": "810-225-0033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8609 W GRAND RIVER AVE",
"address_2": "SUITE 201",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481164398",
"telephone_number": "810-225-0022",
"fax_number": "810-225-0033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIMM",
"first_name": "KEVIN",
"middle_name": "SCOTT",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2008-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901015657",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MI
- Kathryn Justine Grembo, M.A., CCC-SLP
- Jennifer Gretzema
- Rachel Mary Grier, LLMFT
- Stacie Michelle Griffin, M.D.
- Cameron Michael Griffith, P.T.
- Chelsea Groenewegen
- Shoshana M Gruber, NP-C
- Sarah Kathrine Gualano, MD
- Guardian Pharmacy of Grand Rapids, LLC (Guardian Pharmacy of Eastern Michigan)
- Judy Anne Guerin, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.