Stephanie Kristine Grodecki, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS045040 Issued in PA

Practice address

2301 E Allegheny Ave
Philadelphia, PA 19134-4427

Phone

(215) 282-8000

NPI assigned

May 21, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1194517490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 N HANCOCK ST APT N210",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191232342",
            "telephone_number": "240-372-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 E ALLEGHENY AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191344427",
            "telephone_number": "215-282-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODECKI",
        "first_name": "STEPHANIE",
        "middle_name": "KRISTINE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS045040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dara Michelle Grobman, DO
• Jes Grobman, LSW
• Jessica Grochowski, MOT,OTR/L
• Elizabeth Grodanz
• Guirlette Grodecki, M.D
• Wlodzimierz Grodecki, M.D.
• Barry Dennis Groder, D.D.S.
• Michael Ryan Grodsky, MD
• Carolyn Groener, MSOT
• Peter W Groeneveld, M.D.

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.