Warren Kirkland Graham, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DD816 Issued in NM

Practice address

1001 W Broadway Ste D
Farmington, NM 87401-5638

Phone

(505) 325-9133

Fax

(505) 325-9113

NPI assigned

Jul 15, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1912923566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W BROADWAY STE D",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015638",
            "telephone_number": "505-325-9133",
            "fax_number": "505-325-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W BROADWAY STE D",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015638",
            "telephone_number": "505-325-9133",
            "fax_number": "505-325-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "WARREN",
        "middle_name": "KIRKLAND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44933",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DD816",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jan A Gotta, M.D.
• Grace Place for Women, Incorporated
• Tracie D Grace, FNP-C
• Derek Jay Graff, D.M.D.
• Jean Graham, M.D.
• Jeffrey S Grant, M.D.
• Christine Graves, APRN
• Jo Allison Green-Dragony, M.S.JD CCC SLP
• Cailin Green
• Sharon Green, LMSW

• General Practice Dentistry in Farmington, NM
• Providers in Farmington, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.