Active NPI
Shannon Kiran Grewal
- General Practice Dentistry
- Troy, MI
National Provider Identifier
1801683347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901602645
- Practice address
- 111 E Long Lake Rd
Troy, MI 48085-5524 - Phone
- (248) 879-2300
- NPI assigned
- Apr 21, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901602645 | MI | Primary |
Addresses
Primary practice location
111 E Long Lake Rd
Troy, MI 48085-5524
Mailing address
111 E Long Lake Rd
Troy, MI 48085-5524
Phone (248) 879-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901602645 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745193600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1801683347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E LONG LAKE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480855524",
"telephone_number": "248-879-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E LONG LAKE RD",
"city": "TROY",
"state": "MI",
"postal_code": "480855524",
"telephone_number": "248-879-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREWAL",
"first_name": "SHANNON",
"middle_name": "KIRAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-04-21",
"last_updated": "2025-06-02",
"certification_date": "2025-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901602645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.