Kristal Greniuk-Wioncek, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16140 Issued in MI

Practice address

Otsego Dental Group
785 M-32
Gaylord, MI 48735-4873

Phone

(989) 448-2664

NPI assigned

Mar 23, 2007

Sex

Female

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Dental Smiles of Livonia, PC

  • General Practice Dentistry
  • Gaylord, MI
  • NPI 1124154539
  NPD Authorized official
• Maple Dentistry PLLC

  • Dental Clinic/Center
  • Livonia, MI
  • NPI 1275202020
  NPD (past)

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1194842468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 WOODVALE TRL",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481148149",
            "telephone_number": "734-634-4077",
            "fax_number": "734-525-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OTSEGO DENTAL GROUP",
            "address_2": "785 M-32",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "487354873",
            "telephone_number": "989-448-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENIUK-WIONCEK",
        "first_name": "KRISTAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "16140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Gaylord, MI
• Providers in Gaylord, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.