Individual provider Active NPI

Reena Grewal, DDS

  • General Practice Dentistry
  • Burton, MI
National Provider Identifier
1184850182
Registry record updated Jan 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20031 Issued in MI
Practice address
5475 Davison Rd
Burton, MI 48509-1520
Phone
(810) 736-9778
Fax
(810) 736-3269
NPI assigned
Jun 4, 2009
Last updated
Jan 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 20031 MI Primary

Addresses

Primary practice location

5475 Davison Rd
Burton, MI 48509-1520

Mailing address

7350 Coldspring LN
West Bloomfield, MI 48322-4213
Phone (248) 808-5059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204000315 MI Order and Referring Only - DentistPractitioner - Dentist 1850559808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20031MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Today's Dental Comfort Past Accepting new patients
Seva Home Care LLC PastSince Sep 28, 2011 Accepting new patients
Jeffery B. Bundy DDS PC Dba Todays Dental Comfort Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Oakland Home Care, LLCWest Bloomfield, MI, CCN 237547 Home health agency 5% Or Greater Indirect Ownership Interest (11.11%) Jan 1, 2012
Sven Medical BillingWest Bloomfield, MI, CCN 231664 Hospice 5% Or Greater Indirect Ownership Interest (11.11%) Sep 28, 2018

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1184850182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 COLDSPRING LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224213",
            "telephone_number": "248-808-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 DAVISON RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091520",
            "telephone_number": "810-736-9778",
            "fax_number": "810-736-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "REENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "20031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

Verify at the official NPI Registry.