Thomas Nelson Gronau, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

19339 Issued in OH

Practice address

1439 Rombach Ave
Suite 1
Wilmington, OH 45177-1990

Phone

(937) 382-7100

Fax

(937) 382-5662

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790900629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1439 ROMBACH AVE",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451771990",
            "telephone_number": "937-382-7100",
            "fax_number": "937-382-5662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1439 ROMBACH AVE",
            "address_2": "SUITE 1",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451771990",
            "telephone_number": "937-382-7100",
            "fax_number": "937-382-5662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONAU",
        "first_name": "THOMAS",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "19339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2028479",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "9185355",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Taylor S Groneck, PSYD
• Roxanne Rose Groseth, WHNP-BC
• Kadie Irene Grundy
• Benjamin K Grzelak, CDCA
• Jennifer Linette Habermehl, CDCA

• Dentist in Wilmington, OH
• Providers in Wilmington, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.