MEDICARE: DR. BERNARD L. GRADOVILLE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7250	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619958600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNARD L. GRADOVILLE D.D.S.

Provider Business Mailing Address
First Line	:	2800 INGERSOLL AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50312-4013
Country	:	US
Telephone Number	:	515-243-2412
Fax Number	:	515-243-1248

Provider Business Practice Location Address
First Line	:	2800 INGERSOLL AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50312-4013
Country	:	US
Telephone Number	:	515-243-2412
Fax Number	:	515-243-1248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1538828678 — INGERSOLL FAMILY DENTISTRY
Practice Location Address:

2800 INGERSOLL AVE
DES MOINES, IA
50312-4013

Practice Phone: 515-243-2412
Practice Fax:

1659204386 — SILVER CREEK RESIDENTIAL SUPPORT SERVICES LLC
Practice Location Address:

2015 GRAND AVE STE 230
DES MOINES, IA
50312-4903

Practice Phone: 515-721-4494
Practice Fax:

1467291336 — MR. JACOB KIRTS LMHC
Practice Location Address:

600 42ND ST
DES MOINES, IA
50312-2701

Practice Phone: 515-255-8399
Practice Fax:

1295732931 — JEFFREY S CARITHERS MD
Practice Location Address:

535 40TH ST
DES MOINES, IA
50312-3503

Practice Phone: 515-277-5555
Practice Fax: 515-277-0060

1922007640 — JEFFREY JAMES HELLER D.C.
Practice Location Address:

2925 INGERSOLL AVE , STE 2
DES MOINES, IA
50312-4052

Practice Phone: 515-277-2925
Practice Fax: 515-274-8732

1124020805 — DR. RONALD STEVEN BERGMAN D.O.
Practice Location Address:

2000 GRAND AVE
DES MOINES, IA
50312-4920

Practice Phone: 515-222-1111
Practice Fax: 515-244-9914

Directions to “ DR. BERNARD L. GRADOVILLE D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.