Cory A Grathwol, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

019031567 Issued in IL

Practice address

47 E Chicago Ave Ste 344
Naperville, IL 60540-5360

Phone

(630) 778-9500

Fax

(630) 778-9521

NPI assigned

Jun 17, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• C & N Grathwol DMD P.C.

  • Pediatric Dentistry
  • Naperville, IL
  • NPI 1033953641
  NPD Authorized official
• Cory Grathwol, DMD and Nicole Gange , DMD PLLC

  • Pediatric Dentistry
  • Naperville, IL
  • NPI 1750259941
  NPD (past)

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

{
    "created_epoch": "1466121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1467802736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 E CHICAGO AVE STE 344",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405360",
            "telephone_number": "630-778-9500",
            "fax_number": "630-778-9521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 E CHICAGO AVE STE 344",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405360",
            "telephone_number": "630-778-9500",
            "fax_number": "630-778-9521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRATHWOL",
        "first_name": "CORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-17",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019031567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latoya Lashawn Granderson, OWNER
• Gregory S Grant, MD
• Theresa Grant, DPT
• Grassi Retina MD SC
• Michael A Grassi, MD
• Jennifer Gray, APRN
• Julia M Gray, PT
• Lisa M Gray, LCSW
• Sarah M Gray
• Greatland Home Health Services, Inc.

• Pediatric Dentistry in Naperville, IL
• Providers in Naperville, IL by specialty
• Pediatric Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.