Active NPI
Alla Sipora Grossman, DMD
- General Practice Dentistry
- Saint Louis, MO
National Provider Identifier
1841304474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- MO015730
- Practice address
- 9433 Olive Blvd Ste 200
Saint Louis, MO 63132-3132 - Phone
- (314) 993-6706
- Fax
- (314) 993-1263
- NPI assigned
- Aug 19, 2006
- 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 | MO015730 | MO | Primary |
Addresses
Primary practice location
9433 Olive Blvd Ste 200
Saint Louis, MO 63132-3132
Mailing address
9433 Olive Blvd Ste 200
Saint Louis, MO 63132-3132
Phone (314) 993-6706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160113000157 | MO | Order and Referring Only - Dentist | 8527360213 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO015730 | MO | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven P Grossman DDS PC | Past | Accepting new patients |
Interoperability endpoints
- alla.grossman.p1@direct.affiniahealthcare.nextgenshare.com
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841304474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9433 OLIVE BLVD STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631323132",
"telephone_number": "314-993-6706",
"fax_number": "314-993-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9433 OLIVE BLVD STE 200",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631323132",
"telephone_number": "314-993-6706",
"fax_number": "314-993-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSSMAN",
"first_name": "ALLA",
"middle_name": "SIPORA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MO",
"license": "MO015730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- 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.