Great River Orthodontic Specialists, SC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

1001026 Issued in WI

Legal business name

GREAT RIVER ORTHODONTIC SPECIALISTS, SC

Practice address

1200 Main St
La Crosse, WI 54601-4468

Phone

(608) 782-6778

NPI assigned

Aug 22, 2016

Organization subpart

No

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

Authorized official

Name

Brenda Sawyer

Title

Director of Operations

Phone

(715) 835-5182

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Holly J Grimslid, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • La Crosse, WI
  • NPI 1023348729
  NPD (past)
• Gerald Heim, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • La Crosse, WI
  • NPI 1326095415
  NPD (past)

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1124573902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 OAKWOOD HILLS PKWY",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547017780",
            "telephone_number": "715-835-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 MAIN ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546014468",
            "telephone_number": "608-782-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER ORTHODONTIC SPECIALISTS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "715-835-5182"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WI",
            "license": "1001026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiya Marie Grass
• Thomas J Grau, MD
• Erica Gravos, RN
• Raven Judy Tracey Gray, RN
• John Frederick Greany, PT, PHD
• Jordan Leigh Green
• Patricia J Green, CRNA
• Rhonda Kirsten Greeno, BSW
• Kathriena Loreanna Greenwell, M.D.
• Ryan B Gregg, AUD

• Orthodontics and Dentofacial Orthopedics Dentistry in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.