Individual provider Active NPI

Surender Sheetal Grover, DDS

  • Dentist
  • Rhinebeck, NY
National Provider Identifier
1386831576
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
055292 Issued in NY
Practice address
187 E Market St
Suite 300
Rhinebeck, NY 12572-1727
Phone
(845) 379-0996
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 055292 NY Primary

Addresses

Primary practice location

187 E Market St
Suite 300
Rhinebeck, NY 12572-1727

Mailing address

187 E Market St
Suite 300
Rhinebeck, NY 12572-1727
Phone (845) 379-0996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151007001974 NY Order and Referring Only - DentistPractitioner - Dentist 3375851595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
055292NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1386831576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 E MARKET ST",
            "address_2": "SUITE 300",
            "city": "RHINEBECK",
            "state": "NY",
            "postal_code": "125721727",
            "telephone_number": "845-379-0996",
            "fax_number": "845-876-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 E MARKET ST",
            "address_2": "SUITE 300",
            "city": "RHINEBECK",
            "state": "NY",
            "postal_code": "125721727",
            "telephone_number": "845-379-0996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVER",
        "first_name": "SURENDER",
        "middle_name": "SHEETAL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rhinebeck, NY

Sources for this page

Verify at the official NPI Registry.