Zachary T Grillo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010565 Issued in CT

Practice address

498 Buckland Rd
South Windsor, CT 06074-3708

Phone

(860) 648-2848

NPI assigned

Jun 30, 2011

Last updated

Jun 25, 2012By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

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

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.

• Grillo Dental, L.L.C.

  • Dentist
  • South Windsor, CT
  • NPI 1164877098
  NPD (past) Authorized official

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1790072510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "498 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743708",
            "telephone_number": "860-648-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743708",
            "telephone_number": "860-648-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "ZACHARY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004011136",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher J Griffin, M.A., L.P.C.
• Grilli Family Dental Care LLC
• Gary F Grilli, D.M.D
• Gary L Grilli, DDS
• Grillo Dental, L.L.C.
• Jennifer C Guerrette
• Peter Joseph Guida, D.D.S.
• Sreenivas Dutt Gunturu, M.D.
• Juhi Gupta, MS,RD,CDCES
• Nancy Hagen, APRN

• General Practice Dentistry in South Windsor, CT
• Providers in South Windsor, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.