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:
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Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467439281 NPPES
Texas MEDICAID 170550101
Texas MEDICAID 049045800
Texas MEDICAID 039607900
Texas MEDICAID 051370400

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