John R Grady DDS SC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

JOHN R GRADY DDS SC

Practice address

522 Water St
Sauk City, WI 53583-1141

Phone

(608) 643-4441

NPI assigned

Jun 22, 2007

Last updated

Jul 27, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Robert Grady, DDSNPI 1245439363

Title

President

Phone

(608) 356-9595

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Robert Grady, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Sauk City, WI
  • NPI 1245439363
  NPD (past) Authorized official

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185494400000",
    "number": "1821294240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 OAK ST",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539132168",
            "telephone_number": "608-356-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 WATER ST",
            "city": "SAUK CITY",
            "state": "WI",
            "postal_code": "535831141",
            "telephone_number": "608-643-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R GRADY DDS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-27",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-356-9595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33602700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Randall J Hohenstein, DC
• Home Body Counseling, LCC
• Steven J Johnson, M.D.
• Kelly Michelle Jorgensen, PHARMD
• Olivia Kay Joyce, PTA
• Rachel M Kaderavek, PA
• Kira Stamm Key, COTA

• Orthodontics and Dentofacial Orthopedics Dentistry in Sauk City, WI
• Providers in Sauk City, WI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.