Matthew M Grau, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

11312 Issued in MN

Practice address

2850 Curve Crest Blvd W Ste 115
Stillwater, MN 55082-4073

Phone

(651) 439-8764

Fax

(651) 439-9660

NPI assigned

May 4, 2006

Last updated

Feb 3, 2016By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in MN

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

State licenses

Practice roles

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

• Land of Lakes Endodontics PA

  • Endodontics
  • Stillwater, MN
  • NPI 1710108022
  NPD (past) Authorized official

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1467400515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 CURVE CREST W BLVD 115",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824073",
            "telephone_number": "651-439-8764",
            "fax_number": "651-439-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 CURVE CREST BLVD W STE 115",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824073",
            "telephone_number": "651-439-8764",
            "fax_number": "651-439-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAU",
        "first_name": "MATTHEW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "11312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6806273",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1",
            "identifier": "237L1LA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicolette Gott, PHARM D
• Kaitlyn Goulet, M.S. CCC-SLP
• Grace Medical Inc.
• Grand St Paul CVS LLC (CVS Pharmacy #16353)
• Vashti Rose Graphenteen, DPT
• Heather L Gray, PHYSICIAN ASSISTANT
• Mary Gray
• Great Lakes Oral & Maxillofacial Surgery, P.a.
• Elizabeth Ann Griffin, PA-C
• Asher Grogan

• Endodontics in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Endodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.