NPIMap

Organization Active NPI

Terry V. Gruelle P.S.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Thomas, KY
National Provider Identifier
1275698953
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
4118 Issued in KY
Legal business name
TERRY V. GRUELLE P.S.C.
Practice address
40 N Grand Ave
Suite 301
Fort Thomas, KY 41075-4107
Phone
(859) 441-2369
Fax
(859) 442-3222
NPI assigned
Dec 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Terry Vernon Gruelle, D.M.D.NPI 1669929519
Title
President
Phone
(859) 391-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 4118 KY Primary

Addresses

Primary practice location

40 N Grand Ave
Suite 301
Fort Thomas, KY 41075-4107

Mailing address

40 N Grand Ave
Suite 301
Fort Thomas, KY 41075-4107
Phone (859) 441-2369

Other identifiers 1

IdentifierTypeStateIssuer
6004118300MedicaidKY

National Provider Directory

National Provider Directory

Locations

40 N Grand Ave
Ste 301
Fort Thomas, KY 41075
Phone (859) 441-2369

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275698953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N GRAND AVE",
            "address_2": "SUITE 301",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410754107",
            "telephone_number": "859-441-2369",
            "fax_number": "859-442-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N GRAND AVE",
            "address_2": "SUITE 301",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410754107",
            "telephone_number": "859-441-2369",
            "fax_number": "859-442-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY V. GRUELLE P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRUELLE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "VERNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-391-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "4118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6004118300",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.