Tina Gregorash

Individual provider Active NPI General Practice Dentistry · Brook, IN

NPI 1497600274 · NPPES record last updated Feb 26, 2026

Key facts

NPI
1497600274
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0730163516 (IN)
Practice address
300 S Canal St
Brook, IN 47922-8855
Phone
(765) 248-1280
NPI assigned
Feb 26, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0730163516INMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0730163516 IN Yes

Addresses

Primary practice location

300 S Canal St
Brook, IN 47922-8855

Mailing address

300 S Canal St
Brook, IN 47922-8855
Phone (765) 248-1280

Other providers in Brook, IN

All providers in Brook, IN · General Practice Dentistry in Indiana

Sources for this page

Verify at the official NPI Registry.