Greif Ruvinov Dental Care, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GREIF RUVINOV DENTAL CARE, LLC

Doing business as

Brookside Family Dentistry

Practice address

31 Ofallon SQ
O Fallon, MO 63366-3034

Phone

(636) 240-1750

Fax

(636) 389-5442

NPI assigned

May 24, 2018

Organization subpart

No

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

Authorized official

Name

Stacy M Martin

Title

Office Manager

Phone

(636) 240-1750

Specialties & licenses 1

Addresses

Other names 1

• Brookside Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1790276764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 OFALLON SQ",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663034",
            "telephone_number": "636-240-1750",
            "fax_number": "636-389-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 OFALLON SQ",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633663034",
            "telephone_number": "636-240-1750",
            "fax_number": "636-389-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREIF RUVINOV DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "636-240-1750"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary D Gray, MD
• Alexandra Grbcich
• Lisa N. Greer
• Diane Gregory, COTA/L
• Ronald J Gregory Jr.
• Christine Patricia Grierson, M.A., CCC-SLP
• Chad Eldon Griffin, PLPC
• Andria Griffith, MA PLPC
• Melinda Groenke
• Scott Andrew Grogan, D.C.

• Dentist in O'Fallon, MO
• Providers in O'Fallon, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.