Grace Family Dental

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GRACE FAMILY DENTAL

Practice address

1538 11TH Ave
Longview, WA 98632-4123

Phone

(323) 804-1324

NPI assigned

Sep 9, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Hamid Azizi, DDSNPI 1598200610

Title

Owner

Phone

(323) 804-1324

Specialties & licenses 1

Addresses

Other names 1

• Grace Family Dental Doing business as

Practitioners 1

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

• Hamid Azizi, DDS

  • Dentist
  • Vancouver, WA
  • NPI 1598200610
  NPD Authorized official

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1982325668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324123",
            "telephone_number": "323-804-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 11TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324123",
            "telephone_number": "323-804-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-09",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "AZIZI",
        "authorized_official_first_name": "HAMID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-804-1324",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gretchen M Goodman, MS, CCC-SLP
• Patricia S Goodman, RD
• Suzanne Gosch
• George T Goucher, PA
• Julia Gourley, D.M.D.
• Daniel Gradin, M.D.
• Jason Scott Graeme, PA-C
• J'Aime Ellen Graff, BA, C.C.C.E.
• Marie A. Grant, RPH
• Nicole Dominique Grant, DMD

• Dentist in Longview, WA
• Providers in Longview, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.