Individual provider Active NPI

William Stuart Grove III, D.M.D.

  • General Practice Dentistry
  • Alpharetta, GA
National Provider Identifier
1750487708
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8767 Issued in GA
Practice address
12685 Crabapple Rd
Alpharetta, GA 30004-6339
Phone
(770) 475-3700
Fax
(770) 664-2284
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8767 GA Primary

Addresses

Primary practice location

12685 Crabapple Rd
Alpharetta, GA 30004-6339

Mailing address

12685 Crabapple Rd
Alpharetta, GA 30004-6339
Phone (770) 475-3700

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160301000976 GA Order and Referring Only - DentistPractitioner - Dentist 7315242211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8767GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Crabapple Family Dentistry, LLC Past Accepting new patients

Organizations & group practices 1

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750487708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12685 CRABAPPLE RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046339",
            "telephone_number": "770-475-3700",
            "fax_number": "770-664-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12685 CRABAPPLE RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300046339",
            "telephone_number": "770-475-3700",
            "fax_number": "770-664-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROVE",
        "first_name": "WILLIAM",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "8767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.