Victoria K Grannan-Manchen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19023318 Issued in IL

Practice address

340 W Butterfield Rd
Suite 1D
Elmhurst, IL 60126-5069

Phone

(630) 834-4116

Fax

(630) 834-4114

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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 IL

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 and National Provider Directory roles.

• Victoria Grannan D.D.S. LTD

  • General Practice Dentistry
  • Elmhurst, IL
  • NPI 1588055560
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124132279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 W BUTTERFIELD RD",
            "address_2": "SUITE 1D",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265069",
            "telephone_number": "630-834-4116",
            "fax_number": "630-834-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W BUTTERFIELD RD",
            "address_2": "SUITE 1D",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265069",
            "telephone_number": "630-834-4116",
            "fax_number": "630-834-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANNAN-MANCHEN",
        "first_name": "VICTORIA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19023318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese Marren Gracey, MD
• Marius Dorin Gradianu, D.O.
• Amanda Graf, M.A. BCBA
• Catherine Marie Graham, R.D., L.D.N., C.D.E.
• Joseph Lawrence Graham, DO
• Abbey Marie Graves, PA-C
• Green Door Therapy LLC
• Elizabeth Green, AGPCNP-BC
• Leigh Green, APN-CNP
• Jason H. Greenberg, O.D.

• General Practice Dentistry in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• General Practice Dentistry in Illinois

• 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.