Lisa M Gabrish Grabovac, D.D.S., M.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

12008971 Issued in IN

Practice address

1495 Pope CT
Chesterton, IN 46304-5301

Phone

(219) 926-1068

Fax

(219) 929-1944

NPI assigned

May 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Credentials

Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lgabrishgrabovac28348@direct.neighborhealth.masshiway.net
• Direct secure messaging: lgrabovac171284@direct.bmc.masshiway.net

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.

• Trustees of Boston University

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
  • NPI 1154331916
  Medicare reassignment NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Medical Associates of Ebnhc

  • Community Health Clinic/Center
  • East Boston, MA
  • NPI 1255451597
  NPD
• All Family Dental & Braces, LLC.

  • General Practice Dentistry
  • Merrillville, IN
  • NPI 1083122097

  Pediatric Dentistry

  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114977303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 POPE CT",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463045301",
            "telephone_number": "219-926-1068",
            "fax_number": "219-929-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 POPE CT",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463045301",
            "telephone_number": "219-926-1068",
            "fax_number": "219-929-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABRISH GRABOVAC",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IN",
            "license": "12008971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100209830",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS. CO.",
            "identifier": "749490",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Frain
• Erica L Frederick, OTD, OTR/L
• Emily Maria Fredericks, CPNP
• Mariann J Frigo, OTR
• Nancy A Furcsik, MA, LAT, ATC
• Deborah J Gallas, M.S., CCC-SLP/L
• Anthony Galoozis
• James P. Gano, D.C.
• Deborah G Garceau, OTA
• Maxwell Joseph Garcia, PA-C

• Pediatric Dentistry in Chesterton, IN
• Providers in Chesterton, 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 21, 2022; 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.