Individual provider Active NPI

Gregory Alan Grave, D.D.S.

  • General Practice Dentistry
  • Plano, TX
National Provider Identifier
1922002203
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14055 Issued in TX
Practice address
5800 Coit Rd
Suite 100
Plano, TX 75023-5942
Phone
(972) 758-5300
Fax
(469) 241-0446
NPI assigned
Jun 2, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14055 TX Primary

Addresses

Primary practice location

5800 Coit Rd
Suite 100
Plano, TX 75023-5942

Mailing address

5800 Coit Rd
Suite 100
Plano, TX 75023-5942
Phone (972) 758-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20160315001248 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9931405131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14055TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1922002203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 COIT RD",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235942",
            "telephone_number": "972-758-5300",
            "fax_number": "469-241-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 COIT RD",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235942",
            "telephone_number": "972-758-5300",
            "fax_number": "469-241-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVE",
        "first_name": "GREGORY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.