Granger, Kevin C.
Granger, Kevin C. is an individual health care provider with primary practice located at 2415 Benning Rd Ne , Washington DC 20002-4827. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Granger, Kevin C. can be contacted via phone (202) 396-9679.Contact Information
Primary practice address
2415 Benning Rd Ne
Washington DC 20002-4827
Phone: (202) 396-9679
Fax: (202) 396-9773
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Dentist | 122300000X | T22045 | Texas |
Dental Providers / Dentist | 122300000X | 14112 | Maryland |
Dental Providers / Dentist | 122300000X | 0401411967 | Virginia |
Profile Details
NPI number | 1467439281 |
---|---|
LBN Legal business name | Granger, Kevin C. |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 22nd, 2005 |
Last updated | Jun 29th, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467439281 | NPPES |
Texas | MEDICAID | 170550101 | |
Texas | MEDICAID | 049045800 | |
Texas | MEDICAID | 039607900 | |
Texas | MEDICAID | 051370400 |
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