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GRADY S RANDALL DDS
NPI 1609188531
Dentist - Pediatric Dentistry in Grand Rapids, MI

Active since July 08, 2010PECOS Enrolled
1179 E PARIS AVE SE, GRAND RAPIDS, MI 49546(616) 942-9840 Get Directions Write a Review

NPPES record last updated: March 28, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 17, 2019, Oct 24, 2016 (2 updates tracked since 2016).

About Grady S Randall Dds NPPES

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

GRADY S RANDALL DDS (NPI 1609188531) is an individual pediatric dentistry provider in Grand Rapids, Michigan, licensed in Michigan (2901022570) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609188531
Entity TypeIndividualMale
Primary Taxonomy1223P0221X
Provider Legal NameGRADY S RANDALLCredential: DDS
Location Address1179 E PARIS AVE SEGrand Rapids, MI 49546-8371
Mailing Address1179 E Paris Ave Se Ste 130Grand Rapids, MI 49546-3682 · (616) 942-9840 · Fax (616) 942-0170
Phone(616) 942-9840
Sole ProprietorNo
Enumeration DateJuly 8, 2010
Last NPPES UpdateMarch 28, 20192 updates tracked since enumeration
✔ NPI 1609188531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in MI · 2901022570✔ Licensed in CO · DEN.00201849
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
1179 E PARIS AVE SE, Grand Rapids, MI 49546
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grady S Randall Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49546 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 17

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

KATHRYN BULTMAN L.L.C.
Social Worker (Clinical)
1179 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Kent County (616) 460-1857
SPECTRUM HEALTH PRIMARY CARE PARTNERS
Psychiatry & Neurology (Psychiatry)
1179 E PARIS AVE SE, STE. 220
GRAND RAPIDS, MI 49546
Kent County (616) 454-2004
DR. ROBERT CRAIG PAYNE D.D.S.
Dentist (Pediatric Dentistry)
1179 E PARIS AVE SE, SUITE 130
GRAND RAPIDS, MI 49546
Kent County (616) 942-9840
GREAT LAKES PSYCHIATRIC SERVICES, P.C.
Clinic/Center (Adult Mental Health)
1179 E PARIS AVE SE, SUITE 220
GRAND RAPIDS, MI 49546
Kent County (616) 454-2004
DR. ANDREW M. BEHLER D.O.,M.P.H.
Otolaryngology (Facial Plastic Surgery)
1179 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-5760
ASSOCIATED RETINAL CONSULTANTS, PC
Ophthalmology
1179 E PARIS AVE SE, 250
GRAND RAPIDS, MI 49546
Kent County (616) 942-2406
MS. LOUISE ANN SOMMER LMSW
Social Worker (Clinical)
1179 E PARIS AVE SE, SUITE # 220
GRAND RAPIDS, MI 49546
Kent County (616) 454-2004
DR. JAMES ANTHONY SPOTO DO
Otolaryngology (Facial Plastic Surgery)
1179 E PARIS AVE SE
GRAND RAPIDS, MI 49546
Kent County (616) 252-5760

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 Grady Randall's NPI number?

The NPI number for Grady Randall is 1609188531. It was assigned to this individual provider in the NPPES registry on July 8, 2010.

Where is Grady Randall located?

Grady Randall practices at 1179 E Paris Ave SE, Grand Rapids, MI 49546. The listed phone number is (616) 942-9840.

What is Grady Randall's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

Is Grady Randall enrolled in Medicare?

Yes. Grady Randall is registered in the Medicare PECOS enrollment system.

What insurance does Grady Randall accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental of Michigan and HRI Dental & Vision and 3 other insurers list Grady Randall 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 Grady Randall was last updated on March 28, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.