Mallory Grossman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401414946 Issued in VA

Practice address

1600 Wilson Blvd Ste 620
Arlington, VA 22209-2596

Phone

(703) 524-0288

NPI assigned

Jun 10, 2014

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 6, 2015 through Nov 6, 2027

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 and National Provider Directory roles.

• DRS. Wu and Palabrica, D.D.S., P.C.

  • Dentist
  • Arlington, VA
  • NPI 1801062351
  NPD (past)

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1790198547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CLARENDON BLVD",
            "address_2": "APT 1311",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222013332",
            "telephone_number": "518-588-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 WILSON BLVD STE 620",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "222092596",
            "telephone_number": "703-524-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "MALLORY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401414946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Greenwood
• Colleen Greenwood
• Megan Gregory-Morley, BCBA
• Mary E Gregory, DDS
• Julia Grimson
• Kyle Groth
• Tiwanna Chantrell Grover
• Richard David Gruntz II Jr., DDS
• Richard David Gruntz III, DDS
• Guardian Medical Services LLC

• General Practice Dentistry in Arlington, VA
• Providers in Arlington, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.