NPIMap

Organization Active NPI

Grillo Dental, L.L.C.

  • Dentist
  • South Windsor, CT
National Provider Identifier
1164877098
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
010565 Issued in CT
Legal business name
GRILLO DENTAL, L.L.C.
Practice address
498 Buckland Rd
South Windsor, CT 06074-3708
Phone
(860) 648-2848
Fax
(860) 648-2893
NPI assigned
Apr 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Authorized official

Name
Dr. Zachary Grillo, D.M.D.NPI 1790072510
Title
Partner
Phone
(860) 648-2848

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 010565 CT Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 5791 CT

Addresses

Primary practice location

498 Buckland Rd
South Windsor, CT 06074-3708

Mailing address

498 Buckland Rd
South Windsor, CT 06074-3708
Phone (860) 648-2848

National Provider Directory

National Provider Directory

Locations

498 Buckland Rd
South Windsor, CT 06074
Phone (860) 648-2848

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1164877098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743708",
            "telephone_number": "860-648-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743708",
            "telephone_number": "860-648-2848",
            "fax_number": "860-648-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRILLO DENTAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "GRILLO",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "860-648-2848",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "010565",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "5791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.