David Allen Grisar, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

5018-015 Issued in WI

Practice address

1515 Wisconsin Ave
Grafton, WI 53024-1962

Phone

(262) 377-4130

NPI assigned

Dec 22, 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 WI

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

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.

• Becker and Grisar DDS LTD

  • Dentist
  • Grafton, WI
  • NPI 1114084886
  NPD (past)

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508921420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 WISCONSIN AVE",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241962",
            "telephone_number": "262-377-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 WISCONSIN AVE",
            "city": "GRAFTON",
            "state": "WI",
            "postal_code": "530241962",
            "telephone_number": "262-377-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISAR",
        "first_name": "DAVID",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5018-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Grady
• Grafton Family Eye Care LLC
• Grafton School District
• Grafton Volunteer Fire Department Inc
• Elizabeth Jane Grant, M.S
• Tyler Matthew Grisar, DDS
• Adam Groose, M.S., LAT, PES
• Jennifer Grossmeyer
• Jeremy M Groth, M.D.
• Makaila Emory Groves

• Dentist in Grafton, WI
• Providers in Grafton, WI by specialty
• Dentist in Wisconsin

• 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.