Tyler N Grosso, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50-049667 Issued in NY

Practice address

9205 Rockaway Blvd
Ozone Park, NY 11417-2428

Phone

(718) 843-5544

Fax

(718) 843-0747

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477641835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9205 ROCKAWAY BLVD",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172428",
            "telephone_number": "718-843-5544",
            "fax_number": "718-843-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9205 ROCKAWAY BLVD",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114172428",
            "telephone_number": "718-843-5544",
            "fax_number": "718-843-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSO",
        "first_name": "TYLER",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50-049667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doug Stuart Greenspan, D.C.
• Filipina Exconde Grefaldo, RN
• Keith Greim
• Vincent Peter Grieco, PHARM.D.
• James J Grosso, DMD
• Luis Guillen Jr.
• Peter A Guiney, DO
• Rosalba Guio, COTA
• Miriam Guzman, M.S ED
• Hafsha Hafiz, PHARMD

• General Practice Dentistry in Ozone Park, NY
• Providers in Ozone Park, NY by specialty
• General Practice Dentistry in New York

• 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.