Jesse Aron Grimm, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6226 Issued in NC

Practice address

851 Old Winston Rd
Suite 101
Kernersville, NC 27284-8780

Phone

(336) 996-7770

Fax

(336) 996-7782

NPI assigned

Jun 29, 2006

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

Other identifiers 2

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

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.

• Jesse a. Grimm,DDS PA

  • Dental Clinic/Center
  • Kernersville, NC
  • NPI 1225216377
  NPD (past) Authorized official

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811925647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 OLD WINSTON RD",
            "address_2": "SUITE 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848780",
            "telephone_number": "336-996-7770",
            "fax_number": "336-996-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 OLD WINSTON RD",
            "address_2": "SUITE 101",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848780",
            "telephone_number": "336-996-7770",
            "fax_number": "336-996-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "JESSE",
        "middle_name": "ARON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSES NUMBER",
            "identifier": "6226",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8993337",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cayla Berry Greenway
• John Joseph Grenda, MED, BCBA
• Samantha Griffin
• Tiana Griffin
• Emma Rosenthal Grimes, OT
• Rachel Grogan
• Gabrielle A Gualtieri
• Guardian Pharmacy of Eastern NC, LLC (Southern Pharmacy Services Winston-Salem)
• Chancey Gunnell
• April Gunter, MS, RD, CSG, LDN

• General Practice Dentistry in Kernersville, NC
• Providers in Kernersville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.