Active NPI
Ty Alexander Grabovich, DDS
- Dentist
- Murfreesboro, TN
National Provider Identifier
1164986154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10923
- Practice address
- 790 NW Broad St
Murfreesboro, TN 37129-2766 - Phone
- (615) 867-6360
- NPI assigned
- Jan 24, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10923 | TN | Primary |
Addresses
Primary practice location
790 NW Broad St
Murfreesboro, TN 37129-2766
Mailing address
1214 Whiteside Hill Rd
Wartrace, TN 37183-3029
Phone (931) 224-0088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10923 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548288000000",
"number": "1164986154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 WHITESIDE HILL RD",
"city": "WARTRACE",
"state": "TN",
"postal_code": "371833029",
"telephone_number": "931-224-0088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "790 NW BROAD ST",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371292766",
"telephone_number": "615-867-6360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRABOVICH",
"first_name": "TY",
"middle_name": "ALEXANDER",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-24",
"last_updated": "2019-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "10923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.