Nick Grote Family Dental PA

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

3881 Issued in AR

Legal business name

NICK GROTE FAMILY DENTAL PA

Practice address

611 Jefferson St
Van Buren, AR 72956-5159

Phone

(479) 474-2701

Fax

(479) 474-2701

NPI assigned

Jul 5, 2017

Organization subpart

Yes

Parent organization

NICK GROTE FAMILY DENTAL PAAs reported in NPPES

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

Authorized official

Name

Nicholas Grote, DDS

Title

Owner/Dentist

Phone

(479) 806-6556

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Grote Family Dental Doing business as

Tax ID family

Nick Grote Family Dental PA2 organizations share this tax ID, including this one

Part of

Nick Grote Family Dental PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Nick Grote Family Dental PA

  • General Practice Dentistry
  • Van Buren, AR
  • NPI 1447671862
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Nick Grote Family Dental PA

  • General Practice Dentistry
  • Van Buren, AR
  • NPI 1447671862
  NPPES parent name

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1801317375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 JEFFERSON ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565159",
            "telephone_number": "479-474-2701",
            "fax_number": "479-474-3977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 JEFFERSON ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729565159",
            "telephone_number": "479-474-2701",
            "fax_number": "479-474-2701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "708 Pirates Way",
            "address_purpose": "LOCATION",
            "city": "Cedarville",
            "state": "AR",
            "postal_code": "729329506",
            "country_code": "US",
            "telephone_number": "479-922-6153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NICK GROTE FAMILY DENTAL PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NICK GROTE FAMILY DENTAL PA",
        "enumeration_date": "2017-07-05",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "GROTE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "479-806-6556",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "AR",
            "license": "3881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200268608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201489631",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grote Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Janice Marie Newton, LCSW
• Suh N Niba, M.D.
• McKenna Nichols
• Tracy Lynn Nichols, PT
• Nick Grote Family Dental PA
• Dara Itiel Ochoa
• Optimal Pain and Wellness
• Kelsey Lea Orendorff, MS OTR/L
• Clarissa Faye Danielle Ortega
• Lynae Joy Otten, LCSW

• Public Health Dentistry in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Public Health Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.