Roger Grandgenett DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

D10869 Issued in MN

Legal business name

ROGER GRANDGENETT DDS PA

Practice address

621 E 7TH St
Blue Earth, MN 56013-2516

Phone

(507) 526-2170

Fax

(507) 526-7437

NPI assigned

Mar 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Roger Henry Grandgenett, D.D.S.NPI 1659395580

Title

Owner

Phone

(507) 526-2170

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roger Henry Grandgenett, D.D.S.

  • General Practice Dentistry
  • Blue Earth, MN
  • NPI 1659395580
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1003086810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 E 7TH ST",
            "city": "BLUE EARTH",
            "state": "MN",
            "postal_code": "560132516",
            "telephone_number": "507-526-2170",
            "fax_number": "507-526-7437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 E 7TH ST",
            "city": "BLUE EARTH",
            "state": "MN",
            "postal_code": "560132516",
            "telephone_number": "507-526-2170",
            "fax_number": "507-526-7437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER GRANDGENETT DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "GRANDGENETT",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-526-2170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Blue Earth, MN
• Providers in Blue Earth, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.