Dr. Roy L. Grob, Inc

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

2058 Issued in LA

Legal business name

DR. ROY L. GROB, INC

Practice address

2245 11TH St
Suite C
Mandeville, LA 70471-6497

Phone

(985) 626-4779

Fax

(985) 626-4779

NPI assigned

Aug 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Roy Louis Grob Jr., D.D.S., M.S.

Title

Orthodontist

Phone

(985) 626-4779

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• John Iennusa Jr., DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Mandeville, LA
  • NPI 1033550181
  NPD (past)

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1336331990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 11TH ST",
            "address_2": "SUITE C",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704716497",
            "telephone_number": "985-626-4779",
            "fax_number": "985-626-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 11TH ST",
            "address_2": "SUITE C",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704716497",
            "telephone_number": "985-626-4779",
            "fax_number": "985-626-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ROY L. GROB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "GROB",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "985-626-4779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "LA",
            "license": "2058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082058",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirstie Alexa Dotson, CCC-SLP
• Christina D Doucet, LOTR
• Christopher Douglas, DC
• Dr Pete Cooper PHD LPC-S CLC LLC
• Dr. Brenton G. Schulz, LLC
• Dr. Tintin Devoe a Professional Medical Corporation
• Dream Team of la, Inc.
• Daniele Dubuclet
• Bevann Dubuisson, M.S., LPC
• Kennesha Ducre

• Orthodontics and Dentofacial Orthopedics Dentistry in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.