Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Roger Grannum DDS, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1568600757

Roger Grannum DDS, PC is an Oral and Maxillofacial Surgery (Dentist) in Brooklyn, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

730 Broadway
Brooklyn, NY 11206-4403
Phone: (917) 816-0481
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 052633 (NY)

Record details

NPI number1568600757
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Grannum — Chief Executive Officer · (917) 816-0481
NPI enumeratedJanuary 27, 2009
Last updated in NPPESSeptember 29, 2011
Mailing address131 Knollwood Dr, Watchung, NJ 07069-6245

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