Miguel R Grillo, DDS,PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN17351 Issued in FL

Practice address

9136 Forest Hill Blvd
Wellington, FL 33411-6564

Phone

(561) 784-4670

Fax

(561) 791-1390

NPI assigned

May 14, 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

Medicare fee-for-service enrollment

Enrolled in FL

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

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Dental Wellness of Palm Beach LLC

  • General Practice Dentistry
  • West Palm Beach, FL
  • NPI 1528704574
  NPD Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801001425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9136 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334116564",
            "telephone_number": "561-784-4670",
            "fax_number": "561-791-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9136 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334116564",
            "telephone_number": "561-784-4670",
            "fax_number": "561-791-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLO",
        "first_name": "MIGUEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS,PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN17351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Lynn Grazioso, LMHC
• Greater Florida Anesthesiologists LLC
• Melissa N Greene, APRN
• Damon Seth Grill, R.PH
• Jamie Grill
• Randi Jill Grillo, M.ED
• Eric Grimm, D.O.
• Matthew Charles Grisanty
• Svetlana Grodzitsky, PSY.D.
• Grossmayer Wellness Center LLC

• General Practice Dentistry in Wellington, FL
• Providers in Wellington, FL by specialty
• General Practice Dentistry in Florida

• 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.