Individual provider Active NPI

Erin Anne O'Grodnick, D.M.D.

  • Dentist
  • Lebanon, NJ
National Provider Identifier
1114248846
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DIO2435700 Issued in NJ
Practice address
126 Main St
Lebanon, NJ 08833-2126
Phone
(908) 236-9650
NPI assigned
Jun 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DIO2435700 NJ Primary

Addresses

Primary practice location

126 Main St
Lebanon, NJ 08833-2126

Mailing address

126 Main St
Lebanon, NJ 08833-2126
Phone (908) 236-9650

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22DIO2435700NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Smiles of Hunterdon LLC Dentist CurrentSince Feb 12, 2023 Accepting new patients
Vincent J Schaible & Sallyanne Bonner Past Accepting new patients

Locations

126 Main St
Lebanon, NJ 08833
Phone (908) 236-9650

Organizations & group practices 2

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1114248846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MAIN ST",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088332126",
            "telephone_number": "908-236-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MAIN ST",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088332126",
            "telephone_number": "908-236-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'GRODNICK",
        "first_name": "ERIN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DIO2435700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.