DR. ROGER GRANNUM DDS
NPI 1003993502
Dentist - Oral and Maxillofacial Surgery in Brooklyn, NY

Active since November 01, 2006
760 BROADWAY, ORAL SURGERY ROOM 2C320, BROOKLYN, NY 11206(718) 963-8000(718) 599-4912 Get Directions Write a Review

NPPES record last updated: January 6, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Roger Grannum Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ROGER GRANNUM DDS (NPI 1003993502) is an individual oral and maxillofacial surgery provider in Brooklyn, New York, licensed in New York (50052633) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1003993502
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. ROGER GRANNUMCredential: DDS
Location Address760 BROADWAY, ORAL SURGERY ROOM 2C320Brooklyn, NY 11206
Mailing Address760 Broadway, Oral Surgery Room 2c230Brooklyn, NY 11206 · (718) 963-8000 · Fax (718) 630-3122
Fax(718) 599-4912
Sole ProprietorYes
Enumeration DateNovember 1, 2006
Last NPPES UpdateJanuary 6, 2017
NPI 1003993502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in NY · 50052633
Definition

An oral and maxillofacial surgery dentist specialized in 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.

760 BROADWAY, Brooklyn, NY 11206

Other Identifiers 1

Medicaid03084764NY

Accepted Insurance

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant (Medical)
760 BROADWAY
BROOKLYN, NY 11206
Personal Emergency Response Attendant
760 BROADWAY
BROOKLYN, NY 11206
Nurse Practitioner (Family)
760 BROADWAY
BROOKLYN, NY 11206
Student in an Organized Health Care Education/Training Program
760 BROADWAY
BROOKLYN, NY 11206
Psychiatry & Neurology (Psychiatry)
760 BROADWAY, WOODHULL MEDICAL AND MENTAL HEALTH CENTER
BROOKLYN, NY 11206
Physician Assistant (Medical)
760 BROADWAY
BROOKLYN, NY 11206
Nurse Practitioner (Family)
760 BROADWAY
BROOKLYN, NY 11206
Pharmacist
760 BROADWAY
BROOKLYN, NY 11206

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roger Grannum's NPI number?

The NPI number for Roger Grannum is 1003993502. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Roger Grannum located?

Roger Grannum practices at 760 Broadway Oral Surgery Room 2c320, Brooklyn, NY 11206. The listed phone number is (718) 963-8000.

What is Roger Grannum's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

What insurance does Roger Grannum accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 3 other insurers list Roger Grannum as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Roger Grannum was last updated on January 6, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.