Individual provider Active NPI

Inna Grishin, DDS

  • Dentist
  • Kokomo, IN
National Provider Identifier
1649657321
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12012306A Issued in IN
Practice address
3537 S Lafountain St
Kokomo, IN 46902-3804
Phone
(317) 650-3942
NPI assigned
May 1, 2015
Last updated
Jan 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12012306A IN Primary

Addresses

Primary practice location

3537 S Lafountain St
Kokomo, IN 46902-3804

Mailing address

19427 Grassy Branch Rd
Westfield, IN 46074-0797
Phone (317) 650-3942

Other identifiers 1

IdentifierTypeStateIssuer
12012306AOtherINDENTAL

Other names 1

  • Inna Grishin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160510001231 KS Order and Referring Only - DentistPractitioner - Dentist 7214226554
I20160928001881 IN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214226554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12012306AINMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1649657321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19427 GRASSY BRANCH RD",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460740797",
            "telephone_number": "317-650-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3537 S LAFOUNTAIN ST",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469023804",
            "telephone_number": "317-650-3942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHIN",
        "first_name": "INNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-01",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12012306A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "12012306A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INNA",
            "last_name": "GRISHIN",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kokomo, IN

Sources for this page

Verify at the official NPI Registry.