Organization Active NPI

Family Dental Care LLP

  • General Practice Dentistry
  • Aberdeen, SD
National Provider Identifier
1720198062
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
M933 Issued in SD
Legal business name
FAMILY DENTAL CARE LLP
Practice address
407 6TH Ave SE
Aberdeen, SD 57401-6145
Phone
(605) 226-1867
Fax
(605) 226-3993
NPI assigned
Aug 30, 2006
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Dr. Jason J Grebner, DDSNPI 1407966724
Title
Owner
Phone
(605) 226-1867

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
Durable Medical Equipment & Medical Supplies 332B00000X NU
General Practice Dentistry 1223G0001X M933 SD Primary

Addresses

Primary practice location

407 6TH Ave SE
Aberdeen, SD 57401-6145

Mailing address

407 6TH Ave SE
Aberdeen, SD 57401-6145
Phone (605) 226-1867

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240807003149 SD DME Supplier - Oral Surgery - Dentist 2264979285 Practice locations: Aberdeen, SD

National Provider Directory

National Provider Directory

Locations

221 6th Ave SE
Aberdeen, SD 57401
Phone (605) 226-1867

407 6th Ave SE
Aberdeen, SD 57401
Phone (605) 226-1867

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1720198062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 6TH AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574016145",
            "telephone_number": "605-226-1867",
            "fax_number": "605-226-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 6TH AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574016145",
            "telephone_number": "605-226-1867",
            "fax_number": "605-226-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL CARE LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "GREBNER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-226-1867",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.