Cal Grutz, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2023024441 Issued in MO

Practice address

303 S Osage Ave
Tipton, MO 65081-8470

Phone

(563) 513-9612

NPI assigned

May 3, 2023

Last updated

Jun 26, 2023By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1487343570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1127 ROCK CUT RD",
            "city": "HAZEL GREEN",
            "state": "WI",
            "postal_code": "538119719",
            "telephone_number": "563-513-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S OSAGE AVE",
            "city": "TIPTON",
            "state": "MO",
            "postal_code": "650818470",
            "telephone_number": "563-513-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUTZ",
        "first_name": "CAL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2023024441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bond Drug Store, LLC (Tipton Pharmacy)
• Bristol Care, Inc.
• Nacona Burroughs
• Kelly Jeanne Combs
• Michelle Leigh Felten, FNP-C
• Holly Marie Jackson
• Caleb Johnsen, DDS
• Jordyn Knipp
• Sarah Jane Knipp, MS CCC SLP
• Joanne Marie Koechner

• General Practice Dentistry in Tipton, MO
• Providers in Tipton, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.