Institute of Facial Surgery Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

429 Issued in FL

Legal business name

INSTITUTE OF FACIAL SURGERY INC

Practice address

1093 S Wickham Rd
West Melbourne, FL 32904-1652

Phone

(321) 674-3900

Fax

(321) 722-3303

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lance F Grenevicki, DDS,MD,FACSNPI 1255306866

Title

Ownerdoctor

Phone

(321) 674-3900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lance Francis Grenevicki, MD, DDS, FACS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • West Melbourne, FL
  • NPI 1255306866
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1386855096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 S WICKHAM RD",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041652",
            "telephone_number": "321-674-3900",
            "fax_number": "321-722-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 S WICKHAM RD",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041652",
            "telephone_number": "321-674-3900",
            "fax_number": "321-722-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE OF FACIAL SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "GRENEVICKI",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNERDOCTOR",
        "authorized_official_telephone_number": "321-674-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MD,FACS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Hopping, PTA
• Hospice of Health First Inc.
• Michael W Ice, BCBA
• Indian River Center, LLC
• Infinite Behavior Solutions
• Interventional & Vascular Center, PLLC
• Susan Jackson, PT
• Charles K James, DMD
• Rabia Jamil
• Nardege Jean-Francois Jean, ARNP

• Specialist in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.