Simon Grock, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

26412 Issued in CA

Practice address

4553 Glencoe Ave # 310
Marina del Rey, CA 90292-7906

Phone

(310) 384-3404

NPI assigned

Mar 11, 2016

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Simon Grock DDS Apc

  • General Practice Dentistry
  • Marina del Rey, CA
  • NPI 1184034894
  NPD (past) Authorized official

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1235590787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4553 GLENCOE AVE # 310",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927906",
            "telephone_number": "310-384-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4553 GLENCOE AVE # 310",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927906",
            "telephone_number": "310-384-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCK",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Greely
• Aniyah Green
• Debora Gregory, CFNP
• Oche Griffin
• Charles Grinbaum
• Donna Groves, LMFT
• Lisa Ho Guinan, DMD
• Jill Gungap
• Juan Carlos Gutierrez
• Madeline Haas, MD

• Dentist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.