Brian Michael Grisdela, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022367 Issued in MI

Practice address

PO Box 567
Dimondale, MI 48821-0567

Phone

(517) 646-8226

Fax

(517) 646-7545

NPI assigned

Jun 21, 2017

Last updated

Apr 23, 2025By the provider in NPPES

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

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brian M Grisdela DDS PLLC

  • Dental Clinic/Center
  • Dimondale, MI
  • NPI 1093499121
  NPD Authorized official
• Family Dental Care of Dimondale, PC

  • General Practice Dentistry
  • Dimondale, MI
  • NPI 1629088943
  NPD (past)

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1669992749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 567",
            "city": "DIMONDALE",
            "state": "MI",
            "postal_code": "488210567",
            "telephone_number": "517-646-8226",
            "fax_number": "517-646-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 567",
            "city": "DIMONDALE",
            "state": "MI",
            "postal_code": "488210567",
            "telephone_number": "517-646-8226",
            "fax_number": "517-646-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISDELA",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-21",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca J Coccia, N.P.
• Denise Lynne Cooper, CNP
• Diamondale Nursing Care Center, LLC (Dimondale Nursing Care Center)
• Echo Integrative (Echo Integrative Nonprofit)
• Family Dental Care of Dimondale, PC
• Maryann Hellein
• Sally Hock-Harrison
• Kelly Trawczynski
• Magdalen Rose Kogut, BSN
• Lindsey Seasons Martin

• General Practice Dentistry in Dimondale, MI
• Providers in Dimondale, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.