Active NPI
Lorraine M Grodovich, DMD
- General Practice Dentistry
- Rocky Hill, CT
National Provider Identifier
1225176035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6380
- Practice address
- 2301 Silas Deane Highway
Rocky Hill, CT 06067 - Phone
- (860) 563-3766
- Fax
- (860) 721-0160
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6380 | CT | Primary |
Addresses
Primary practice location
2301 Silas Deane Highway
Rocky Hill, CT 06067
Mailing address
PO Box 65
Rocky Hill, CT 06067
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6380 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225176035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 65",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "06067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 SILAS DEANE HIGHWAY",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "06067",
"telephone_number": "860-563-3766",
"fax_number": "860-721-0160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRODOVICH",
"first_name": "LORRAINE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "6380",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocky Hill, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.