Active NPI
Amy Rebecca Groeltz, DDS
- Dentist
- Burlington, IA
National Provider Identifier
1871714758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 08298
- Practice address
- 210 South 5TH Street
Burlington, IA 52601 - Phone
- (319) 752-1600
- Fax
- (319) 752-1610
- NPI assigned
- May 1, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 08298 | IA | Primary |
Addresses
Primary practice location
210 South 5TH Street
Burlington, IA 52601
Mailing address
402 Hedge Ave
Burlington, IA 52601-6435
Phone (319) 753-0424
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 |
|---|---|---|---|
| 08298 | IA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Shoppe | Dentist | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Burlington, IA
- NPI 1356518500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871714758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 HEDGE AVE",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "526016435",
"telephone_number": "319-753-0424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 SOUTH 5TH STREET",
"city": "BURLINGTON",
"state": "IA",
"postal_code": "52601",
"telephone_number": "319-752-1600",
"fax_number": "319-752-1610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROELTZ",
"first_name": "AMY",
"middle_name": "REBECCA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IA",
"license": "08298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, IA
- Great River Aea 16
- Great River Child Care Inc.
- Great River Eye Care, Inc.
- Brandie Grinstead, LISW
- Grinstead, Pierce & Associates, LLC (O'Rourke, Grinstead, Pierce & Associates)
- Jennifer Hamilton, RN
- Evan J Hammer, RPH
- Harbans Deol DO PHD PC
- Tabithia Spring Harness, LMHC
- Michelle Diane Hartman, FNP-C
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.