Sanford E. Gruskin, D.D.S., M.S.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

7571 Issued in GA

Practice address

259 Arrowhead Blvd Ste a
Jonesboro, GA 30236-1167

Phone

(770) 471-4196

Fax

(770) 477-0505

NPI assigned

Mar 30, 2007

Sex

Male

Sole proprietor

No

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

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.

• Southern Oral Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Griffin, GA
  • NPI 1881629392
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639299704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 ARROWHEAD BLVD STE A",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361167",
            "telephone_number": "770-471-4196",
            "fax_number": "770-477-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 ARROWHEAD BLVD STE A",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361167",
            "telephone_number": "770-471-4196",
            "fax_number": "770-477-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSKIN",
        "first_name": "SANFORD",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "7571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaria Lynette Gregg, REGISTERED BEHAVIOR
• Cameika Gregory, OTR/L
• Greyglyde Transit, LLC.
• Lisa Griffin-Moh
• Judy Griffin
• Caryn Ann Grzesiakowski, DC
• GT Homecare LLC
• Angel M Guardiola, DMD
• Eric Guerra, RPH
• Guiding Hand Perssonal Care Home

• Oral and Maxillofacial Surgery (Dentist) in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Georgia

• 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.