NPIMap

Individual provider Active NPI

Namninder S GRN, DMD

  • Dentist
  • Casa Grande, AZ
National Provider Identifier
1013137827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7016 Issued in AZ
Practice address
1677 E Florence Blvd
#24
Casa Grande, AZ 85222
Phone
(520) 836-5466
Fax
(520) 836-7469
NPI assigned
Apr 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7016 AZ Primary

Addresses

Primary practice location

1677 E Florence Blvd
#24
Casa Grande, AZ 85222

Mailing address

1677 E Florence Blvd
#24
Casa Grande, AZ 85222
Phone (520) 836-5466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D7016AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Impressions at Casa Grande PLC Dentist Past Accepting new patients
Arizona Dental Pavillion Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013137827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1677 E FLORENCE BLVD",
            "address_2": "#24",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85222",
            "telephone_number": "520-836-5466",
            "fax_number": "520-836-7469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1677 E FLORENCE BLVD",
            "address_2": "#24",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "85222",
            "telephone_number": "520-836-5466",
            "fax_number": "520-836-7469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRN",
        "first_name": "NAMNINDER",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.