Active NPI
Lauren Keiko Griebenow, DDS
- General Practice Dentistry
- Kokomo, IN
National Provider Identifier
1356829758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12013001A
- Practice address
- 5111 Clinton Dr
Kokomo, IN 46902-7136 - Phone
- (765) 453-4369
- NPI assigned
- Jul 30, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12013001A | IN | Primary |
Addresses
Primary practice location
5111 Clinton Dr
Kokomo, IN 46902-7136
Mailing address
8855 W 300 S
Russiaville, IN 46979-9529
Phone (765) 513-1922
Other practice location 1
2333 W Lincoln Rd
Kokomo, IN 46902-8012
Phone (765) 455-0085
Other practice location 2
1639 N Cass St
Wabash, IN 46992
Phone (260) 225-0527
Other names 1
- Lauren Keiko Groothuis
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 |
|---|---|---|---|
| 12013001A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ladd Dental Group of Wabash, P.C. | General Practice | 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
- Wabash, IN
- NPI 1134496060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618358400000",
"number": "1356829758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8855 W 300 S",
"city": "RUSSIAVILLE",
"state": "IN",
"postal_code": "469799529",
"telephone_number": "765-513-1922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5111 CLINTON DR",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469027136",
"telephone_number": "765-453-4369"
}
],
"practiceLocations": [
{
"address_1": "2333 W Lincoln Rd",
"address_purpose": "LOCATION",
"city": "Kokomo",
"state": "IN",
"postal_code": "469028012",
"country_code": "US",
"telephone_number": "765-455-0085",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1639 N Cass St",
"address_purpose": "LOCATION",
"city": "Wabash",
"state": "IN",
"postal_code": "46992",
"country_code": "US",
"telephone_number": "260-225-0527",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRIEBENOW",
"first_name": "LAUREN",
"middle_name": "KEIKO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-30",
"last_updated": "2021-04-14",
"certification_date": "2021-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "IN",
"license": "12013001A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "GROOTHUIS",
"middle_name": "KEIKO",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.