Carissa Jael Greinel-Blum

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14244 Issued in MD

Practice address

7007 Wyoming Blvd NE Ste B2
Albuquerque, NM 87109-3982

Phone

(505) 821-1430

Fax

(505) 821-1442

NPI assigned

Sep 30, 2008

Last updated

Apr 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bear Canyon Family Dentistry LLC

  • General Practice Dentistry
  • Albuquerque, NM
  • NPI 1265860936
  NPD (past) Authorized official
• Dr Mason DMD Inc

  • Dental Clinic/Center
  • Albuquerque, NM
  • NPI 1629240486
  NPD (past)

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1710137450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE B2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093982",
            "telephone_number": "505-821-1430",
            "fax_number": "505-821-1442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7007 WYOMING BLVD NE STE B2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093982",
            "telephone_number": "505-821-1430",
            "fax_number": "505-821-1442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREINEL-BLUM",
        "first_name": "CARISSA",
        "middle_name": "JAEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD3005",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Joe Gregory, CCHW
• Tony F Gregory, LPN
• Tyler James Gregurich
• Kylee Greider
• David Brian Greif, DC
• James Greiner, LMHC
• Matthew Joseph Gremillion, MD
• Kristin Grenemyer, RN
• Timothy J Grenemyer, DO
• Michelle Ann Grenier, MD

• General Practice Dentistry in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.