Andrew Grillo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2901021823 Issued in MI

Practice address

600 Shirewood LN
Midland, MI 48642-7065

Phone

(989) 600-8037

NPI assigned

May 23, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Great Lakes Bay Orthodontics, PLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Midland, MI
  • NPI 1336782135
  Authorized official Same address or phone

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1013364736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11323 WOLF DANCER PASS S # 101",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460374706",
            "telephone_number": "989-600-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SHIREWOOD LN",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427065",
            "telephone_number": "989-600-8037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-23",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robin Lynn Greiner, LLMSW
• Kaylee Autumn Grettenberger
• Jason R Greve, MA, LPC
• Alysia Griese, DC
• Kayla Ann Grifka, MSW
• Dean Grimason
• Charra Grist
• Debora Grostick
• Kenneth Eugene Grove Jr., D.D.S.
• Growing Minds Therapy Co PLLC

• Dentist in Midland, MI
• Providers in Midland, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.