Tamar Gruenbaum, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02475500 Issued in NJ

Practice address

385 S Maple Ave
Suite 107
Glen Rock, NJ 07452-1543

Phone

(201) 652-2707

NPI assigned

Jul 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1053609974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W 246TH ST",
            "address_2": "APT 903",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104713611",
            "telephone_number": "201-410-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 S MAPLE AVE",
            "address_2": "SUITE 107",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521543",
            "telephone_number": "201-652-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENBAUM",
        "first_name": "TAMAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-12",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "055625",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02475500",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02475500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Granert, DC
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• Ahmed S Hadi, M.D.
• Stephen F Haggerty, D.D.S.
• Laiann Aiman Hamdan, PA-C
• Alexandra Legregin Harkins

• Pediatric Dentistry in Glen Rock, NJ
• Providers in Glen Rock, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2015; 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.