De Graffenried Dental, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DE GRAFFENRIED DENTAL, PLLC

Practice address

238 Lawrence St
Kilgore, TX 75662-2610

Phone

(903) 984-0614

Fax

(903) 984-3834

NPI assigned

Jan 22, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer Samples

Title

Human Resources

Phone

(903) 984-0614

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• J de Graffenried Dentistry Doing business as

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua Austin De Graffenried, D.D.S

  • Dentist
  • Tyler, TX
  • NPI 1104224930
  NPD (past)

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1962092049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 LAWRENCE ST",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756622610",
            "telephone_number": "903-984-0614",
            "fax_number": "903-984-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 LAWRENCE ST",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756622610",
            "telephone_number": "903-984-0614",
            "fax_number": "903-984-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE GRAFFENRIED DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "SAMPLES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "HUMAN RESOURCES",
        "authorized_official_telephone_number": "903-984-0614",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1831205004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437762622",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "xrays@drjoeydeg.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "238 Lawrence St",
            "city": "Kilgore",
            "state": "TX",
            "country_code": "US",
            "postal_code": "756622610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "J de Graffenried Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cindy R Crye, LPC
• CVS Pharmacy Inc
• Jacqueline Daves, LPA, LCDC
• Jeffrey L Davis, DDS
• Jessica Davis, OTR, MOT
• Joseph Claude De Graffenried Jr., DDS
• Shana Michelle Deal, SLP/CCC
• Hao Deng
• Devan S Derrick, LVN
• Rocco Paul Desantis, DDS

• Dental Clinic/Center in Kilgore, TX
• Providers in Kilgore, TX by specialty
• Dental Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.