Rupp and Grabowski Family Dentistry, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12072 Issued in MN

Legal business name

RUPP AND GRABOWSKI FAMILY DENTISTRY, PA

Practice address

916 W Saint Germain St
#114
Saint Cloud, MN 56301-3424

Phone

(320) 251-1912

Fax

(320) 251-2331

NPI assigned

Jun 21, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Derek Grabowski, DDS

Title

Owner

Phone

(320) 251-1912

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1265753693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 W SAINT GERMAIN ST",
            "address_2": "#114",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013424",
            "telephone_number": "320-251-1912",
            "fax_number": "320-251-2331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 W SAINT GERMAIN ST",
            "address_2": "#114",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013424",
            "telephone_number": "320-251-1912",
            "fax_number": "320-251-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUPP AND GRABOWSKI FAMILY DENTISTRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "GRABOWSKI",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-251-1912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386729291",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538270442",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Rufer, SLP-CCC
• Sharon J Ruggiero, MD
• Adam Forrest Ruggle, M.D.
• Jaimie Linn Ruiz
• Doevoly Ruot Yoa Yat
• Jeffrey Anthony Rupp, DDS
• Rural AIDS Action Network
• Reva Olivia Rush Daniels
• Christine Rushmeyer
• Ashley Ruter

• General Practice Dentistry in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.