Albert Fitz Gruber II, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11979 Issued in TN

Practice address

University of Tennessee College of Dentistry
875 Union Ave
Memphis, IL 38163

Phone

(901) 448-6271

Fax

(708) 339-5567

NPI assigned

Nov 8, 2006

Last updated

Oct 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Artistic Dental Centre

  • Dentist
  • South Holland, IL
  • NPI 1811262223
  NPD (past) Authorized official
• Nse Ekpenyong, DDS, PC

  • Dentist
  • South Holland, IL
  • NPI 1235673419
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1386714210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1697 LISSON LANE",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "38017",
            "telephone_number": "708-212-7995",
            "fax_number": "708-339-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF TENNESSEE COLLEGE OF DENTISTRY",
            "address_2": "875 UNION AVE",
            "city": "MEMPHIS",
            "state": "IL",
            "postal_code": "38163",
            "telephone_number": "901-448-6271",
            "fax_number": "708-339-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBER",
        "first_name": "ALBERT",
        "middle_name": "FITZ",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-019995",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009737A",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6830",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; 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.