Lorelei Lynne Grise', D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

021001648 Issued in IL

Practice address

439 Lake St
Antioch, IL 60002-1472

Phone

(847) 395-3250

Fax

(847) 395-4045

NPI assigned

Apr 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alfred E Roseroot, D.M.D., P.C.

  • Dental Clinic/Center
  • Des Plaines, IL
  • NPI 1548812530
  NPD (past)
• Arlington Heights Dental Group LTD

  • General Practice Dentistry
  • Arlington HTS, IL
  • NPI 1417961848
  NPD (past)
• Dental Health of Wheaton

  • General Practice Dentistry
  • Wheaton, IL
  • NPI 1952428153
  NPD (past)
• McBeth Dental

  • Dental Clinic/Center
  • Wheaton, IL
  • NPI 1104310150
  NPD (past)
• Suburban Family Dental

  • Oral and Maxillofacial Surgery (Dentist)
  • Des Plaines, IL
  • NPI 1295978104

  Periodontics

  NPD (past)
• Paul D Smith D.D.S., S.C. Dba Jackson Park Family Dental

  • Dentist
  • Milwaukee, WI
  • NPI 1558023622
  NPD (past)

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1003939992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "848 S BRISTOL LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600052728",
            "telephone_number": "847-797-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 LAKE ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021472",
            "telephone_number": "847-395-3250",
            "fax_number": "847-395-4045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3520 W Oklahoma Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532154175",
            "country_code": "US",
            "telephone_number": "414-645-0365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "949 W Liberty Dr",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601874846",
            "country_code": "US",
            "telephone_number": "630-668-6071",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "645 W Golf Rd",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600162462",
            "country_code": "US",
            "telephone_number": "847-640-0778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1455 E Golf Rd Ste 216",
            "address_purpose": "LOCATION",
            "city": "Des Plaines",
            "state": "IL",
            "postal_code": "600161254",
            "country_code": "US",
            "telephone_number": "847-699-3370",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16 Executive Ct Ste 1",
            "address_purpose": "LOCATION",
            "city": "South Barrington",
            "state": "IL",
            "postal_code": "600109528",
            "country_code": "US",
            "telephone_number": "847-373-3936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 Landover Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Hawthorn Woods",
            "state": "IL",
            "postal_code": "600477513",
            "country_code": "US",
            "telephone_number": "847-550-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISE'",
        "first_name": "LORELEI",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-07",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022485",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": "021001648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reesa Gorenstein, ED.S
• Grass Lake School Dist No 36
• Jill Marie Grass, RBT
• Colleen Mary Green
• Alecia Grever, LCPC
• Claudia Gutierrez
• Chanel Hampton
• Lisa Hanes, RBT-18-48335
• Richard A Hartmann, PT, MS, ATC
• Michaela Hartzer, LCPC

• All providers in Antioch, IL
• Periodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.