BRETT C GRAY (NPI# 1619085362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619085362 |
| Entity Type | Individual |
| Full Name | BRETT C GRAY |
| Credential | DMD MD |
| Practice Address |
1463 Klondike Road Suite C Conyers GA 30094 |
| Practice Telephone | 7704839692 |
| Practice Fax Number | 6784871004 |
| Mailing Telephone | 7704839692 |
| Mailing Fax Number | 6784871004 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
7235 | KY | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
047755 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205456860 | Brett Gray | Occupational Therapist | 611 W Park St, Urbana, IL 61801-2529 | 2020-04-23 |
| 1992285258 | Brett Gray | Behavior Technician | 733 Dante St, New Orleans, LA 70118-1013 | 2018-08-16 |
| 1013212950 | Brett Gray | Nurse Practitioner | 180 Fort Washington Ave, Hp2, New York, NY 10032-3722 | 2011-01-25 |
| 1538158969 | Brett Mcneil Gray | Family Medicine | 900 N Owen Walters Blvd, Salina, OK 74365-5003 | 2005-10-18 |
| Street Address |
1463 KLONDIKE ROAD SUITE C |
| City | CONYERS |
| State | GA |
| Zip Code | 30094 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366550063 | Steven D Pollack | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1669580312 | Steven P King | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1376651034 | Robert E Going Jr. | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1558479253 | Fulton D Lewis IIi | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029054 | Darlene Fletcher | Counselor | 827 St. Clair Dr., Conyers, GA 30094 | 2020-10-05 |
| 1194363366 | Clara A Matthews | Physician Assistant | 1930 Windsor Creek Drive Sw, Conyers, GA 30094 | 2019-12-18 |
| 1659838571 | Sensitive Home Care Agency Inc. | PACE Provider Organization | 2225 Morning Dew, Conyers, GA 30094 | 2019-02-27 |
| 1679097992 | Sheira Dennis | Case Management | 3828 Martingale Dr Se, Conyers, GA 30094 | 2017-07-28 |
| 1730571399 | Wellness and Trauma Recovery Center | Counselor | 1775 Parker Rd. Building C, Suite 210, Conyers, GA 30094 | 2015-02-19 |
| 1760870612 | Michael Terrell | Technician/Technologist | 806 Cambridge Creek Dr, Conyers, GA 30094 | 2014-12-30 |
| 1538567466 | Jennifer Angela Johnson | Registered Nurse | 2240 Wren Rd Se, Conyers, GA 30094 | 2014-12-09 |
| 1225445208 | Wanda Marcella Rainey-reed | Counselor | 1453 Klondike Rd Sw Ste D, Conyers, GA 30094 | 2014-07-22 |
| 1508155268 | Nicklaus Trent Rice | Obstetrics & Gynecology | 2750 Owens Dr, Conyers, GA 30094 | 2011-04-04 |
| 1720219660 | Candace Alexander | Dentist | 863 Flat Shoals Rd Se, Suite C #220, Conyers, GA 30094 | 2009-07-27 |
| Find all providers in zip 30094 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619085396 | Gordon L Brady | Dentist | 1463 Klondike Rd, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1366550063 | Steven D Pollack | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1942478755 | Brenda Jean Hall | Dentist | 1463 Klondike Rd Sw, Suite C, Conyers, GA 30094-5127 | 2008-02-14 |
| 1669580312 | Steven P King | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1750499414 | Richard S Singer | Dentist | 1463 Klondike Rd, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1376651034 | Robert E Going Jr. | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| 1003924788 | Oral Surgery Associates & Dental Implant Center PC | Dentist | 1463 Klondike Rd, Ste C, Conyers, GA 30094 | 2006-08-25 |
| 1558479253 | Fulton D Lewis IIi | Dentist | 1463 Klondike Road, Suite C, Conyers, GA 30094 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370454 | Karin Davis, Dmd, PC | Dentist | 3630 Savannah Pl Ste 250, Duluth, GA 30096-6394 | 2020-09-08 |
| 1649740796 | Sandy Springs Oral Surgery, LLC | Dentist | 5555 Peachtree Dunwoody Rd Ste G56, Atlanta, GA 30342-1700 | 2018-12-02 |
| 1700354677 | Cobb Oral Surgery and Dental Implant Center PC | Dentist | 2155 Post Oak Tritt Rd Ste 500, Marietta, GA 30062-8609 | 2018-11-08 |
| 1245721216 | East Atlanta Oral, Implant and Facial Surgery Center | Dentist | 519 Memorial Dr Se Unit D1, Atlanta, GA 30312-2218 | 2018-05-24 |
| 1497261960 | Rockwell Oral and Facial Surgery LLC | Dentist | 675 N. Highland Ave Ne, Suite 100, Atlanta, GA 30306 | 2017-12-20 |
| 1225543515 | Oral & Facial Surgery of East Alabama, LLC | Dentist | 4405 N Stadium Drive, Suite A, Columbus, GA 31909 | 2017-12-08 |
| 1194271445 | Dina Amin | Dentist | 1365 Clifton,building B, Oral and Maxillofacial Surgery, Suite 2300, Atlanta, GA 30322 | 2016-08-28 |
| 1457735995 | Coastal Oral Surgery Associates | Dentist | 110 Office Park Ln, Suite 104, Saint Simons Island, GA 31522-6601 | 2015-07-15 |
| 1497140719 | Chelsea Elizabeth Johnson | Dentist | 4405 N Stadium Dr Ste A, Columbus, GA 31909-1884 | 2015-04-02 |
| 1386038396 | Timothy C Jaeger | Dentist | 1360 Caduceus Way Ste 101, Watkinsville, GA 30677-7300 | 2015-03-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.