Active NPI
Timothy M Grinder, DDS
- General Practice Dentistry
- Cary, NC
National Provider Identifier
1871689133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5595
- Practice address
- 580 New Waverly PL
210
Cary, NC 27518-7406 - Phone
- (919) 851-1040
- Fax
- (919) 851-8986
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5595 | NC | Primary |
Addresses
Primary practice location
580 New Waverly PL
210
Cary, NC 27518-7406
Mailing address
201 Victor Hugo Dr
Cary, NC 27511
Phone (919) 388-9122
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93439 | Other | NC | BLUE CROSS BLUE SHIELD |
| 570722 | Other | UNITED CONCORIDA INS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5595 | NC | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392076800000",
"number": "1871689133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 VICTOR HUGO DR",
"city": "CARY",
"state": "NC",
"postal_code": "27511",
"telephone_number": "919-388-9122",
"fax_number": "919-851-8986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "580 NEW WAVERLY PL",
"address_2": "210",
"city": "CARY",
"state": "NC",
"postal_code": "275187406",
"telephone_number": "919-851-1040",
"fax_number": "919-851-8986"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRINDER",
"first_name": "TIMOTHY",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2014-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "5595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "93439",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORIDA INS",
"identifier": "570722",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.