Individual provider Active NPI

Louis Michael Grillon, D.D.S.

  • General Practice Dentistry
  • Chicopee, MA
National Provider Identifier
1063497170
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15603 Issued in MA
Practice address
436 Chicopee St
Chicopee, MA 01013-1941
Phone
(413) 533-0528
NPI assigned
Dec 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15603 MA Primary

Addresses

Primary practice location

436 Chicopee St
Chicopee, MA 01013-1941

Mailing address

436 Chicopee St
Chicopee, MA 01013-1941
Phone (413) 533-0528

Other identifiers 1

IdentifierTypeStateIssuer
15603OtherMADENTAL LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20150310001380 MA Order and Referring Only - DentistPractitioner - Dentist 5890011852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063497170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 CHICOPEE ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010131941",
            "telephone_number": "413-533-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 CHICOPEE ST",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010131941",
            "telephone_number": "413-533-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLON",
        "first_name": "LOUIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "15603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE #",
            "identifier": "15603",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicopee, MA

Sources for this page

Verify at the official NPI Registry.