Kirstina Jessica Gratz, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12013407A Issued in IN

Practice address

21781 Omega CT
Goshen, IN 46528-7809

Phone

(319) 430-8601

NPI assigned

Jul 30, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Good to Grow Dental Center, PLLC

  • Pediatric Dentistry
  • Goshen, IN
  • NPI 1174141741
  NPD Authorized official
• James a. Kouba, D.D.S., P.C.

  • General Practice Dentistry
  • Bloomfield, IA
  • NPI 1588707921
  NPD (past)

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

{
    "created_epoch": "1311984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1083992689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13618 RANIER DR",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465408640",
            "telephone_number": "641-208-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21781 OMEGA CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287809",
            "telephone_number": "319-430-8601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATZ",
        "first_name": "KIRSTINA",
        "middle_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-30",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08858",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12013407A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gotwals
• Jonathan C Graber, NP
• Anna Weaver Grady, MD
• Susanne Walker Graham, LCSW, MSW
• Cynthia J Grate, LCSW
• Green Oaks of Goshen, LLC
• Alyssa Green, M.A.
• Nicole Greenlee, FNP
• Mallory A Grossman, NP
• Maire Catherine Grupp, LSW

• Pediatric Dentistry in Goshen, IN
• Providers in Goshen, IN by specialty
• Pediatric Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.