Derek P Grzanich, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

29339 Issued in TX

Practice address

9016 N Allen Rd
Suite B
Peoria, IL 61615-1513

Phone

(309) 690-4500

Fax

(309) 690-4500

NPI assigned

Oct 20, 2006

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

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.

• Associates in Dentistry

  • Dentist
  • Peoria, IL
  • NPI 1538241278
  NPD (past)

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1487736112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5518 W BROOKMERE DRIVE",
            "city": "EDWARDS",
            "state": "IL",
            "postal_code": "615289407",
            "telephone_number": "309-683-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9016 N ALLEN RD",
            "address_2": "SUITE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151513",
            "telephone_number": "309-690-4500",
            "fax_number": "309-690-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZANICH",
        "first_name": "DEREK",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019026724",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "29339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaybriana Groth, PHARMD
• Leslie M Gruber, MOT,OTR/L
• Lindsey N Gruenwald, PA-C
• Aleshka Grusy, PTA
• Lindsey Lorraine Grys, APN
• Michael Grzeskowiak
• Troy Gubler, DPM
• Sarah Anne Gudeman, PTA
• Cynthia I Guede, APRN
• Christine Guerrini, M.D.

• Endodontics in Peoria, IL
• Providers in Peoria, IL by specialty
• Endodontics in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.