William Henry Grotz IV, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1917438 Issued in IL

Practice address

4815 W 103Rd Street
Oak Lawn, IL 60453

Phone

(708) 425-5001

Fax

(708) 423-0727

NPI assigned

Feb 22, 2007

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 IL

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

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720113855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15100 ALPINE DRIVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677362",
            "telephone_number": "708-460-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 W 103RD STREET",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-425-5001",
            "fax_number": "708-423-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTZ",
        "first_name": "WILLIAM",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "1917438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dornica D Griffin
• Kelly Ann Griffin, NP
• Linda Griffis, PT
• Jaime Lynn Groetsema, PHARM. D
• Katie Gross
• Growth & Guidance Counseling LLC
• Marissa Guerrero, MSN, FNP-BC
• Juana Emperatriz Guevara
• Victoria Gugala, PA-C
• Anthony Guglielmi, MD

• General Practice Dentistry in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.