Organization Active NPI

Grove Street Dental PC

  • General Practice Dentistry
  • Jersey City, NJ
National Provider Identifier
1184737496
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI20129 Issued in NJ
Legal business name
GROVE STREET DENTAL PC
Practice address
175 Newark Ave
Jersey City, NJ 07302
Phone
(201) 200-0222
Fax
(201) 435-7678
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Vladimir DranovskyNPI 1427046440
Title
President
Phone
(201) 200-0222

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X DI20129 NJ Primary

Addresses

Primary practice location

175 Newark Ave
Jersey City, NJ 07302

Mailing address

PO Box 345
Jersey City, NJ 07303
Phone (201) 200-0222

Other identifiers 1

IdentifierTypeStateIssuer
5170907MedicaidNJ

National Provider Directory

National Provider Directory

Locations

175 Newark Ave
Jersey City, NJ 07302
Phone (201) 200-0222

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184737496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 345",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07303",
            "telephone_number": "201-200-0222",
            "fax_number": "201-435-7678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 NEWARK AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07302",
            "telephone_number": "201-200-0222",
            "fax_number": "201-435-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVE STREET DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRANOVSKY",
        "authorized_official_first_name": "VLADIMIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-200-0222",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI20129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5170907",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.