Active NPI
Patrick Grube, D.D.S
- Dentist
- Virginia Beach, VA
National Provider Identifier
1316398183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0401415233
- Practice address
- 242 Mustang TRL
Suite 9
Virginia Beach, VA 23452-7515 - Phone
- (757) 340-1153
- NPI assigned
- Jun 23, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401415233 | VA | Primary |
Addresses
Primary practice location
242 Mustang TRL
Suite 9
Virginia Beach, VA 23452-7515
Mailing address
242 Mustang TRL
Suite 9
Virginia Beach, VA 23452-7515
Phone (757) 340-1153
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401415233 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Thomas J. O'Hara | Past | 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.
-
- General Practice Dentistry
- Virginia Beach, VA
- NPI 1912113119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1316398183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "242 MUSTANG TRL",
"address_2": "SUITE 9",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234527515",
"telephone_number": "757-340-1153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "242 MUSTANG TRL",
"address_2": "SUITE 9",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234527515",
"telephone_number": "757-340-1153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBE",
"first_name": "PATRICK",
"credential": "D.D.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-23",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401415233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.