NPIMap

Organization Active NPI

Grant Road Dental

  • General Practice Dentistry
  • Mountain View, CA
National Provider Identifier
1659896827
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33512 Issued in CA
Legal business name
GRANT ROAD DENTAL
Practice address
1040 Grant Rd Ste 105
Mountain View, CA 94040-3274
Phone
(650) 938-8127
Fax
(650) 230-4925
NPI assigned
Aug 9, 2017
Organization subpart
Yes
Parent organization
LOS GATOS DENTAL SPECIALISTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Authorized official

Name
Robert Rutner, DDSNPI 1629180617
Title
Owner
Phone
(650) 938-8127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 33512 CA Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X

Addresses

Primary practice location

1040 Grant Rd Ste 105
Mountain View, CA 94040-3274

Mailing address

15075 Los Gatos Blvd Ste 120
Los Gatos, CA 95032-2049
Phone (408) 884-8155

National Provider Directory

National Provider Directory
Tax ID family
Los Gatos Dental Specialists2 organizations share this tax ID, including this one
Part of
Los Gatos Dental Specialists

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1040 Grant Rd
Ste 105
Mountain View, CA 94040
Phone (650) 314-0100

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1502236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502236800000",
    "number": "1659896827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15075 LOS GATOS BLVD STE 120",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322049",
            "telephone_number": "408-884-8155",
            "fax_number": "408-252-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GRANT RD STE 105",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940403274",
            "telephone_number": "650-938-8127",
            "fax_number": "650-230-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT ROAD DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOS GATOS DENTAL SPECIALISTS",
        "enumeration_date": "2017-08-09",
        "last_updated": "2017-08-09",
        "status": "A",
        "authorized_official_last_name": "RUTNER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-938-8127",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33512",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2017; 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.