NPIMap

Individual provider Active NPI

Brent R Grafe, D.D.S.

  • Endodontics
  • Evansville, IN
National Provider Identifier
1992914345
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
12007991A Issued in IN
Practice address
2709 Washington Ave
Evansville, IN 47714-2411
Phone
(812) 476-8000
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 12007991A IN Primary

Addresses

Primary practice location

2709 Washington Ave
Evansville, IN 47714-2411

Mailing address

2709 Washington Ave
Evansville, IN 47714-2411
Phone (812) 476-8000

Other names 1

  • Dr. Brent R Grafe Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12007991AINMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992914345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142411",
            "telephone_number": "812-476-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477142411",
            "telephone_number": "812-476-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAFE",
        "first_name": "BRENT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IN",
            "license": "12007991A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENT",
            "last_name": "GRAFE",
            "middle_name": "R",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • 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.