Mark L Grosko, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

21555 Issued in OH

Practice address

843 N 21St St
Suite 103
Newark, OH 43055-7273

Phone

(740) 344-6349

Fax

(740) 344-6350

NPI assigned

Dec 5, 2007

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

Other identifiers 7

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.

• Mark L Grosko DDS Inc

  • Endodontics
  • Newark, OH
  • NPI 1548316094
  NPD (past) Authorized official

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1265614861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 N 21ST ST",
            "address_2": "SUITE 103",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430557273",
            "telephone_number": "740-344-6349",
            "fax_number": "740-344-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 N 21ST ST",
            "address_2": "SUITE 103",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430557273",
            "telephone_number": "740-344-6349",
            "fax_number": "740-344-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSKO",
        "first_name": "MARK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-05",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "OH",
            "license": "21555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR DENTAL",
            "identifier": "440265",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2424693",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "256022",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9185647",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1400162",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMP BENEFITS",
            "identifier": "187028",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "25 1901759027",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Winters Griley
• Scott Randall Grim, LISW, LICDC
• Thomas Matthew Grogan, M.D.
• Crystal Grooms
• Selena Marie Grooms
• Karen Spencer Gross, LISW-S
• Esteban Grovas Cordovi
• Dash Carter Grove
• Holly Grover
• Chelsea Lavonne Groves

• Endodontics in Newark, OH
• Providers in Newark, OH by specialty
• Endodontics in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.