Individual provider Active NPI

David E. Grauer, D.D.S.

  • General Practice Dentistry
  • Park Ridge, IL
National Provider Identifier
1255398970
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019-10474 Issued in IL
Practice address
101 S Washington St
135
Park Ridge, IL 60068-4200
Phone
(847) 696-3240
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 019-10474 IL Primary

Addresses

Primary practice location

101 S Washington St
135
Park Ridge, IL 60068-4200

Mailing address

808 S Seminary Ave
Park Ridge, IL 60068-4431
Phone (847) 825-4254

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
019-10474ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grauer-Kuchta Dental As PastSince Aug 19, 2004 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255398970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S SEMINARY AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684431",
            "telephone_number": "847-825-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S WASHINGTON ST",
            "address_2": "135",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684200",
            "telephone_number": "847-696-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUER",
        "first_name": "DAVID",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-10474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

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.

Verify at the official NPI Registry.