John Coalson Grissom, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14639 Issued in TX

Practice address

210 N Park Blvd
Suite 110
Grapevine, TX 76051-6985

Phone

(817) 488-8175

Fax

(817) 488-7995

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982729372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N PARK BLVD",
            "address_2": "SUITE 110",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760516985",
            "telephone_number": "817-488-8175",
            "fax_number": "817-488-7995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N PARK BLVD",
            "address_2": "SUITE 110",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760516985",
            "telephone_number": "817-488-8175",
            "fax_number": "817-488-7995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISSOM",
        "first_name": "JOHN",
        "middle_name": "COALSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shara Kay Green, LPC
• Sharon Lee Greene, LCSW
• Gregory Allen Golly Crna, PC
• Russell Gregory, MA,LPC-A
• Vicki Grissett, PT
• Sarah Marie Valor Groce, PA-C
• Leslie Grove, LPC
• William Michael Grover, DDS, PA
• Growth by Choice Counseling, PLLC
• Peter M Gruman, MSN, RN, FNP-BC

• General Practice Dentistry in Grapevine, TX
• Providers in Grapevine, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.