Individual provider Active NPI

Terry Gruelle

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Thomas, KY
National Provider Identifier
1669929519
Registry record updated Sep 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
4118 Issued in KY
Practice address
40 N Grand Ave
Suite 301
Fort Thomas, KY 41075-4107
Phone
(859) 441-2369
Fax
(859) 442-3222
NPI assigned
Sep 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 4118 KY Primary

Addresses

Primary practice location

40 N Grand Ave
Suite 301
Fort Thomas, KY 41075-4107

Mailing address

40 N Grand Ave
Suite 301
Fort Thomas, KY 41075-4107
Phone (859) 441-2369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4118KYMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Tso PLLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Terry V. Gruelle P.S.C. Orthodontics and Dentofacial Orthopedics Past Accepting new patients
Dig Orthodontics LLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1669929519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 N GRAND AVE",
            "address_2": "SUITE 301",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410754107",
            "telephone_number": "859-441-2369",
            "fax_number": "859-442-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N GRAND AVE",
            "address_2": "SUITE 301",
            "city": "FORT THOMAS",
            "state": "KY",
            "postal_code": "410754107",
            "telephone_number": "859-441-2369",
            "fax_number": "859-442-3222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUELLE",
        "first_name": "TERRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "4118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thomas, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.