Stephen H Grossman, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

14579 Issued in MA

Practice address

77 Great Road
Suite 206
Acton, MA 01720

Phone

(978) 263-1313

Fax

(978) 264-4440

NPI assigned

Aug 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lexington Periodontics & Implantology, LLC

  • Periodontics
  • Lexington, MA
  • NPI 1144346644
  NPD (past)

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114930559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 GREAT ROAD",
            "address_2": "SUITE 206",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "01720",
            "telephone_number": "978-263-1313",
            "fax_number": "978-264-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 GREAT ROAD",
            "address_2": "SUITE 206",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "01720",
            "telephone_number": "978-263-1313",
            "fax_number": "978-264-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "14579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Road Acupuncture and Herbs LLC
• Great Road Dental Associates,P.C
• Greene Nutrition, LLC (Greene Nutrition)
• William Gresser, M.A.
• Zachary Gresser, LMHC
• Jillian Guarino
• Kendra Guinness, BCBA, LABA
• Kristie A Hadley, CNP
• Sachiko Hall
• Emily P. Harder, M.D.

• Periodontics in Acton, MA
• Providers in Acton, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.