Healthcare Provider Details

I. General information

NPI: 1013529437
Provider Name (Legal Business Name): NICHOLAS PETER GRIGGS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E ROYALTON RD
BROADVIEW HEIGHTS OH
44147-2549
US

IV. Provider business mailing address

376 CALVIN DR
SEVEN HILLS OH
44131-2853
US

V. Phone/Fax

Practice location:
  • Phone: 440-546-0330
  • Fax:
Mailing address:
  • Phone: 330-671-9305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12016
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: