CHARLES FREDERICK GRANNUM (NPI# 1205904208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205904208 |
| Entity Type | Individual |
| Full Name | CHARLES FREDERICK GRANNUM |
| Credential | MD |
| Practice Address |
1536 Bedford Ave Brooklyn NY 11216-4117 |
| Mailing Address |
Po Box 29889 New York NY 10087-9889 |
| Practice Telephone | 8003765566 |
| Mailing Telephone | 8003765566 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
040024 | NY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | LICENSE | 040024 | 01 |
| Street Address |
1536 BEDFORD AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11216-4117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226781 | Maame-ama A Antwi | Student in an Organized Health Care Education/Training Program | 1536 Bedford Ave, Brooklyn, NY 11216-4117 | 2020-08-24 |
| 1073122743 | Lawrence Shum | Student in an Organized Health Care Education/Training Program | 1536 Bedford Ave, Brooklyn, NY 11216-4117 | 2020-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437776960 | Alicia Jones | Optometrist | 1530 Bedford Avenue, Brooklyn, NY 11216 | 2020-06-30 |
| 1255984613 | Raushanah A. Smith | Registered Nurse | 141 Madison St., #1, Brooklyn, NY 11216 | 2019-07-24 |
| 1871073171 | Jillian N Beam | Counselor | 763-765 Nostrand Ave, Ste#1, Brooklyn, NY 11216 | 2018-08-16 |
| 1598250086 | Hope Lakeisha Garvin | Social Worker | 763-765 Nostrand Ave, Brooklyn, NY 11216 | 2018-06-27 |
| 1982192233 | Katharine Ha | Social Worker | 278 Quincy St. #4, Brooklyn, NY 11216 | 2018-04-23 |
| 1205340254 | Bed Stuy Acupuncture and Massage Therapy Pllc | Acupuncturist | 1069 Bedford Ave Storefront, Brooklyn, NY 11216 | 2017-11-29 |
| 1619497104 | Aras Occupational Therapy Pllc | Occupational Therapist | 29 Macdonough St, 4g, Brooklyn, NY 11216 | 2017-06-26 |
| 1033648621 | Yaneth Lombana | Social Worker | 1399 Pacific St. 2nd Floor, Brooklyn, NY 11216 | 2017-06-07 |
| 1922495944 | James Leroy Barry Robinson Jr. | Social Worker | 3 Macdonough St Apt 4l, Brooklyn, NY 11216 | 2015-04-16 |
| 1033539572 | Omnisleep LLC | Residential Treatment Facility, Physical Disabilities | 763- Nostrand Avenue, Omnicare Multisplecialty, Brooklyn, NY 11216 | 2014-04-23 |
| Find all providers in zip 11216 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382143 | Weon Jae Choi | Dentist | 22 N 6th St Apt 9o, Brooklyn, NY 11249-3083 | 2020-09-29 |
| 1306492731 | Penny Planzos | Dentist | 7815 4th Avenue, Brooklyn, NY 11209 | 2019-08-12 |
| 1891195541 | Charles Walowitz | Dentist | 1 Grand Army Plz, Apt 5-c, Brooklyn, NY 11238-5611 | 2014-08-31 |
| 1306256797 | Lior Furman | Dentist | 7506 Avenue T, Brooklyn, NY 11234-6207 | 2014-05-06 |
| 1790064376 | Gary Alan Nord Jr. | Dentist | 127 Meserole St, Apt #2b, Brooklyn, NY 11206-2189 | 2011-08-12 |
| 1003065087 | Antonella Milio | Dentist | 3030 Emmons Ave Apt 4u, Brooklyn, NY 11235-2227 | 2008-09-15 |
| 1790992022 | Alan S Broner | Dentist | 773 Montgomery St, Brooklyn, NY 11213-5278 | 2007-05-17 |
| 1295723203 | Antoine E Chiha | Dentist | 8440 Fort Hamilton Pkwy, Brooklyn, NY 11209-4806 | 2005-10-12 |
| 1194324400 | Clinton Street Dental Pllc | Dentist | 139 Clinton St, Ste 1, Brooklyn, NY 11201 | 2020-10-19 |
| 1669746533 | Edward S. Stiel | Dentist | 2469 65th St, Brooklyn, NY 11204-4170 | 2012-02-23 |
| Find all providers in BROOKLYN | ||||
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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.