Jacquelyn C. Grillo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48605 Issued in CA

Practice address

1258 Harvard Ave
Claremont, CA 91711-3818

Phone

(909) 624-1919

NPI assigned

Jan 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417000555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 HARVARD AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 HARVARD AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917113818",
            "telephone_number": "909-624-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "JACQUELYN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Graves, ATC
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• Merceades Quinniece Green, MS, CCC-SLP
• Karen Greenbaum-Maya, PH. D.
• Jennifer Kaminski Guerra, MSPA-C
• Karen Michelle Uy-Uyan Guiang, D.O.
• Wendy J Guilbert-Neal, MSPT
• Roy A. Guizado, P.A.-C.
• Brittany Gundel, PH.D.

• General Practice Dentistry in Claremont, CA
• Providers in Claremont, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.