Hansrolf Hildebrandt Gruener, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE00005832 Issued in WA

Practice address

830 Metcalf St
Sedro Woolley, WA 98284

Phone

(360) 855-0351

Fax

(360) 855-9357

NPI assigned

Dec 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Sedro Woolley Family Dental Center, P.S.

  • Dental Clinic/Center
  • Sedro Woolley, WA
  • NPI 1184963845
  NPD (past) Authorized official
• Sedro-Woolley Family Dental Center

  • General Practice Dentistry
  • Sedro-Woolley, WA
  • NPI 1902121155
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457410433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 METCALF ST",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "98284",
            "telephone_number": "360-855-0351",
            "fax_number": "360-855-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 METCALF ST",
            "city": "SEDRO WOOLLEY",
            "state": "WA",
            "postal_code": "98284",
            "telephone_number": "360-855-0351",
            "fax_number": "360-855-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENER",
        "first_name": "HANSROLF",
        "middle_name": "HILDEBRANDT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00005832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "5312GR",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "82145",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5007604",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "757623",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelly Grant
• Kilee Rose Green
• Billie Griffeth, RN
• Pamela Grime
• Margaret E Griswold, R.D., C.D.
• Kimberlee Laurel Guerrero
• Haley Louise Guesford, NC61073133
• Brenden Hall, RPH
• Christine Halterman, LICSW
• Dora Maria Halverson

• Dentist in Sedro Woolley, WA
• Providers in Sedro Woolley, WA by specialty
• Dentist in Washington

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.