Active NPI
Jason L Grosch, DDS
- General Practice Dentistry
- St. Charles, MO
National Provider Identifier
1467546366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2001023743
- Practice address
- 2408 Highway 94 South
St. Charles, MO 63303 - Phone
- (636) 928-4888
- Fax
- (636) 928-4108
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2001023743 | MO | Primary |
Addresses
Primary practice location
2408 Highway 94 South
St. Charles, MO 63303
Mailing address
2408 Highway 94 South
St. Charles, MO 63303
Phone (636) 928-4888
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 |
|---|---|---|---|
| 2001023743 | MO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467546366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2408 HIGHWAY 94 SOUTH",
"city": "ST. CHARLES",
"state": "MO",
"postal_code": "63303",
"telephone_number": "636-928-4888",
"fax_number": "636-928-4108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2408 HIGHWAY 94 SOUTH",
"city": "ST. CHARLES",
"state": "MO",
"postal_code": "63303",
"telephone_number": "636-928-4888",
"fax_number": "636-928-4108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSCH",
"first_name": "JASON",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "2001023743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Charles, MO
Sources for this page
- 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.