Individual provider Active NPI

Rachel Grandinetti

  • General Practice Dentistry
  • Charlotte, NC
National Provider Identifier
1053999037
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12936 Issued in NC
Practice address
13425 Hoover Creek Blvd Ste 204
Charlotte, NC 28273-0170
Phone
(980) 999-5007
NPI assigned
Mar 31, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RES.004363 OH
Student in an Organized Health Care Education/Training Program 390200000X OH
General Practice Dentistry 1223G0001X 12936 NC Primary

Addresses

Primary practice location

13425 Hoover Creek Blvd Ste 204
Charlotte, NC 28273-0170

Mailing address

13425 Hoover Creek Blvd Ste 204
Charlotte, NC 28273-0170
Phone (980) 999-5007

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
12936NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Mark Hostrander, DDS, PLLC CurrentSince Jan 12, 2025 Accepting new patients

Locations

13425 Hoover Creek Blvd
Ste 204
Charlotte, NC 28273
Phone (704) 865-6856

Organizations & group practices 1

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736121600000",
    "number": "1053999037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13425 HOOVER CREEK BLVD STE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730170",
            "telephone_number": "980-999-5007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13425 HOOVER CREEK BLVD STE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282730170",
            "telephone_number": "980-999-5007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDINETTI",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES.004363",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.