Individual provider Active NPI

Pete Grubnich, DDS

  • Dentist
  • Merrillville, IN
National Provider Identifier
1487724076
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7993 Issued in IN
Practice address
2464 W Lincoln Hwy
Merrillville, IN 46410-5245
Phone
(219) 769-6241
Fax
(219) 769-6248
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7993 IN Primary

Addresses

Primary practice location

2464 W Lincoln Hwy
Merrillville, IN 46410-5245

Mailing address

2464 W Lincoln Hwy
Merrillville, IN 46410-5245
Phone (219) 769-6241

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

LicenseStateTypeSpecialty
7993INMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487724076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2464 W LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105245",
            "telephone_number": "219-769-6241",
            "fax_number": "219-769-6248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2464 W LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105245",
            "telephone_number": "219-769-6241",
            "fax_number": "219-769-6248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBNICH",
        "first_name": "PETE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "7993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

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.

Verify at the official NPI Registry.