Individual provider Active NPI

Alex W Grech, DDS

  • General Practice Dentistry
  • Sheboygan, WI
National Provider Identifier
1346379799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5171-015 Issued in WI
Practice address
638 Riverfront Dr
Sheboygan, WI 53081-4629
Phone
(920) 457-1717
NPI assigned
Mar 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5171-015 WI Primary

Addresses

Primary practice location

638 Riverfront Dr
Sheboygan, WI 53081-4629

Mailing address

2411 Lakeshore Dr
Sheboygan, WI 53081-6347
Phone (020) 803-9534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160421000269 WI Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779881917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5171-015WIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346379799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 LAKESHORE DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530816347",
            "telephone_number": "020-803-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 RIVERFRONT DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530814629",
            "telephone_number": "920-457-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRECH",
        "first_name": "ALEX",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5171-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.