DR. HEATHERLY HENSON GRISSOM (NPI# 1699921965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699921965 |
| Entity Type | Individual |
| Full Name | DR. HEATHERLY HENSON GRISSOM |
| Credential | D.M.D. |
| Practice Address |
1896 Main St Suite B Madison MS 39110-7676 |
| Practice Telephone | 6018989390 |
| Practice Fax Number | 6018989395 |
| Mailing Telephone | 6018989390 |
| Mailing Fax Number | 6018989395 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
3228-02 | MS | Dental Providers |
| Street Address |
1896 MAIN ST SUITE B |
| City | MADISON |
| State | MS |
| Zip Code | 39110-7676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821137316 | Dental Care of Madison | Dentist | 1896 Main St, Suite B, Madison, MS 39110-7676 | 2007-02-05 |
| 1699921957 | Jason Scott Grissom | Dentist | 1896 Main St, Suite B, Madison, MS 39110-7676 | 2008-08-18 |
| 1114069465 | Braden Mcinteer | Dentist | 1896 Main St, Ste B, Madison, MS 39110-7676 | 2007-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134784689 | Therapy South - Gluckstadt LLC | Physical Therapist | 1716 Us 51, Ste N, Madison, MS 39110 | 2019-05-09 |
| 1871054098 | Summit Medical Solutions | Durable Medical Equipment & Medical Supplies | 107 Azalea Street, Madison, MS 39110 | 2019-03-29 |
| 1912488198 | Madison Medical Compounding Pharmacy | Pharmacy | 111 Fountains Blvd. Building B Ste. A, Madison, MS 39110 | 2018-08-24 |
| 1679061469 | Nuvena Vein Clinic | Anesthesiology | 120 Fountains Blvd, Madison, MS 39110 | 2018-04-26 |
| 1467960484 | Brick City Drugs, LLC | Durable Medical Equipment & Medical Supplies | 159 Fountains Blvd, Madison, MS 39110 | 2018-01-11 |
| 1093227589 | Hannah Monk Hawthorne | Counselor | 930 Ebenezer Blvd., Suite D, Madisin, MS 39110 | 2017-10-25 |
| 1548786650 | Kimberly Allen | Pharmacist | 1100 Us- 51, Madison, MS 39110 | 2017-08-21 |
| 1891218186 | Delta Elizabeth Stark | Chiropractor | 1085 Gluckstadt Rd., Bld 300 Ste E, Madison, MS 39110 | 2017-07-19 |
| 1861914848 | Laura Hartlein | Dietitian, Registered | 200 Park Circle Dr. #2, Flowood, MS 39110 | 2017-07-12 |
| 1831620608 | Ona Irby | Occupational Therapist | 105 Munich Dr, Madison, MS 39110 | 2017-03-23 |
| Find all providers in zip 39110 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700496007 | Elizabeth R Friend | Dentist | 440 Science Dr Ste 100, Madison, WI 53711-1064 | 2020-08-03 |
| 1841817657 | Kimberly Nicole Lee | Dentist | 105 Broadmoor Dr, Madison, MS 39110-6651 | 2020-06-26 |
| 1831713213 | Scarlett La'ree Johnson | Dentist | 155 Millhouse Dr, Madison, MS 39110-6964 | 2020-06-02 |
| 1447899653 | Say Ahh Family and Cosmetic Dentistry LLC | Dentist | 7559 Highway 72 W Ste 105a105b, Madison, AL 35758-8811 | 2020-01-06 |
| 1982245395 | Treehouse Children's Dentistry, LLC | Dentist | 7559 Highway 72 W Ste 108, Madison, AL 35758-8816 | 2019-10-07 |
| 1205480423 | Abtin Iranmanesh | Dentist | 7564 Highway 72 W Ste C, Madison, AL 35758-9437 | 2019-07-25 |
| 1396238226 | Nathalie M Gomez-leon | Dentist | 7278 Highway 72 W Ste A, Madison, AL 35758-9551 | 2018-06-14 |
| 1164915518 | Lauren Faustmann | Dentist | 20 Hughes Rd # 104, Madison, AL 35758-2237 | 2018-06-11 |
| 1669963518 | Fahad Al-fadhli | Dentist | 109 Sycamore Rdg, Madison, MS 39110-7333 | 2018-05-27 |
| 1346752441 | Pignataro Family Dentistry, PC | Dentist | 7950 Highway 72 W Ste F, Madison, AL 35758-6420 | 2017-10-30 |
| Find all providers in MADISON | ||||
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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.