Active NPI
Suzanne Grey
- Orthodontics and Dentofacial Orthopedics Dentistry
- Eau Claire, WI
National Provider Identifier
1447750088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 1001716-15
- Practice address
- 3902 Oakwood Hills Pkwy
Eau Claire, WI 54701-7780 - Phone
- (715) 835-5182
- NPI assigned
- Feb 20, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 1001716-15 | WI | Primary |
Addresses
Primary practice location
3902 Oakwood Hills Pkwy
Eau Claire, WI 54701-7780
Mailing address
3902 Oakwood Hills Pkwy
Eau Claire, WI 54701-7780
Phone (715) 835-5182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1001716-15 | WI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519084800000",
"number": "1447750088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3902 OAKWOOD HILLS PKWY",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547017780",
"telephone_number": "715-835-5182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3902 OAKWOOD HILLS PKWY",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547017780",
"telephone_number": "715-835-5182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREY",
"first_name": "SUZANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2018-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WI",
"license": "1001716-15",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.