Christiana Ann Griswold – General Practice Dentistry

Key facts

NPI: 1376955385
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 2901021217 (MI)
Practice address: 10101 Margaret Dr
Pinckney, MI 48169-8627
Phone: (269) 271-4621
NPI assigned: May 24, 2014
Sex: Female
Sole proprietor: Yes

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.

Griswold Family Dentistry PLC Dental Clinic/Center · Scottville, MI · NPI 1215679816

NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20160602000939	MI	Order and Referring Only - Dentist Practitioner - Dentist	5799075826

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
2901021217	MI	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Griswold Family Dentistry PLC		Current	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	2901021217	MI	Yes

Addresses

Primary practice location

10101 Margaret Dr
Pinckney, MI 48169-8627

Mailing address

10101 Margaret Dr
Pinckney, MI 48169-8627
Phone (269) 271-4621

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 24, 2014.

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400889600000",
    "number": "1376955385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 MARGARET DR",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481698627",
            "telephone_number": "269-271-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 MARGARET DR",
            "city": "PINCKNEY",
            "state": "MI",
            "postal_code": "481698627",
            "telephone_number": "269-271-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISWOLD",
        "first_name": "CHRISTIANA",
        "middle_name": "ANN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-24",
        "last_updated": "2014-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901021217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinckney, MI

All providers in Pinckney, MI · General Practice Dentistry in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2014. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.