Simon Grock DDS Apc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SIMON GROCK DDS APC

Practice address

4553 Glencoe Ave # 310
Marina del Rey, CA 90292-7906

Phone

(310) 384-3404

NPI assigned

May 2, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Simon Grock, DDSNPI 1235590787

Title

Corp.President

Phone

(310) 384-3404

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Simon Grock, DDS

  • Dentist
  • Marina del Rey, CA
  • NPI 1235590787
  NPD (past) Authorized official

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1184034894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 GLENCOE AVE # 310",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927906",
            "telephone_number": "310-384-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 GLENCOE AVE # 310",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927906",
            "telephone_number": "310-384-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMON GROCK DDS APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "GROCK",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "CORP.PRESIDENT",
        "authorized_official_telephone_number": "310-384-3404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Wall Shore, M.D.
• Brett I. Shore, MD
• Elinaz Shoushtari Moghaddam, D.D.S.
• John Sico, PT, DPT
• Farhad Sigari, MD
• Mallory Sinclair
• Robert D Slay, MD
• Jennifer Slevin, PHARM.D.
• Rose Hickman Smith, LMFT
• Terese Higbie Smith, MSPT

• General Practice Dentistry in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.