Grasse River Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GRASSE RIVER FAMILY DENTAL

Doing business as

Grasse River Family Dental

Practice address

1956 Old Dekalb Rd
Canton, NY 13617-3134

Phone

(315) 386-2960

Fax

(315) 386-2960

NPI assigned

Dec 15, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Keli R Hollis, DDSNPI 1487885505

Title

Dentist/Owner

Phone

(315) 386-2960

Specialties & licenses 1

Addresses

Other names 1

• Grasse River Family Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keli Rose Hollis, D.D.S.

  • General Practice Dentistry
  • Canton, NY
  • NPI 1487885505
  NPD Authorized official
• Curt D Ross, DDS

  • Dentist
  • Canton, NY
  • NPI 1659432490
  NPD (past)

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

{
    "created_epoch": "1607990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607990400000",
    "number": "1629664511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 OLD DEKALB RD",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173134",
            "telephone_number": "315-386-2960",
            "fax_number": "315-386-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 OLD DEKALB RD",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136173134",
            "telephone_number": "315-386-2960",
            "fax_number": "315-386-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRASSE RIVER FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-15",
        "last_updated": "2020-12-15",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "HOLLIS",
        "authorized_official_first_name": "KELI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "315-386-2960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grasse River Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donna Gokey
• Lauren Gomes, RDH
• Weston Goring, DPM
• Jennifer M Gotham
• Susan M Grandaw
• Patricia Len Green, PTA
• Alison Marie Greene, PT, DPT
• Lisa Marie Guccione, PTA
• Jill Guiles
• Lauren Guilfoil

• Dental Clinic/Center in Canton, NY
• Providers in Canton, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2020; 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.