DR. KIMBERLY GRADY DDS
NPI 1154310647
Dentist - General Practice in Jbsa Lackland, TX

Q: What is the provider's specialty?

The provider's specialty is Dentist with taxonomy code 1223G0001X and a focus in General Practice.

Active since October 18, 2005

1100 WILFORD HALL LOOP, BLDG 4554 ATTN 59 MDW/SGHC, JBSA LACKLAND, TX 78236(210) 292-6255 Get Directions Write a Review

NPPES record last updated: January 27, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 27, 2021, Apr 20, 2018, Mar 27, 2017 (3 updates tracked since 2017).

On this page

About Dr. Kimberly Grady Dds NPPES

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

DR. KIMBERLY GRADY DDS (NPI 1154310647) is an individual general practice provider in Jbsa Lackland, Texas, licensed in Massachusetts (19560) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1154310647

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KIMBERLY GRADYCredential: DDS

Location Address1100 WILFORD HALL LOOP, BLDG 4554 ATTN 59 MDW/SGHCJbsa Lackland, TX 78236-9908

Mailing Address1100 Wilford Hall Loop Bldg 4554Jbsa Lackland, TX 78236-5638 · (210) 539-8239

Phone(210) 292-6255

Sole ProprietorNo

Enumeration DateOctober 18, 2005

Last NPPES UpdateJanuary 27, 20213 updates tracked since enumeration

NPPES CertifiedJanuary 27, 2021

✔ NPI 1154310647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MA · 19560

Definition

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.

1100 WILFORD HALL LOOP, Jbsa Lackland, TX 78236

Open in Google Maps ↗