Robert Grode, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D-4663 Issued in ID

Practice address

4920 South 30TH Street
Suite 103
Omaha, NE 68107-1656

Phone

(402) 734-4110

Fax

(402) 991-5642

NPI assigned

Jul 9, 2015

Sex

Male

Sole proprietor

No

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 NE

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": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478649600000",
    "number": "1861875726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 SOUTH 30TH STREET",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 SOUTH 30TH STREET",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-991-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODE",
        "first_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2016-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D-4663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron Grizzle, RN, BSN
• Carly Grobeck
• Cheenee Santos Grobeck
• Luke Grobeck, RBT
• Lalena Delja Grochowski
• Jessica Groeneweg
• Dominic Evin Groenhagen-Bolden
• Roxane Marie Groenhagen
• Brena Groeper
• Melissa A Groff, PA

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.