Active NPI
Michael Joseph Von Gruben, D.D.S.
- Pediatric Dentistry
- New Orleans, LA
National Provider Identifier
1871804146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- S-633
- Practice address
- 1100 Florida Ave
New Orleans, LA 70119-2714 - Phone
- (504) 619-8770
- NPI assigned
- Jul 1, 2010
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | S-633 | LA | Primary |
Addresses
Primary practice location
1100 Florida Ave
New Orleans, LA 70119-2714
Mailing address
325 Focis St
Metairie, LA 70005-3433
Phone (225) 772-4499
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S-633 | Medicaid | LA |
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 |
|---|---|---|---|
| S-633 | LA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1871804146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 FOCIS ST",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700053433",
"telephone_number": "225-772-4499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 FLORIDA AVE",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701192714",
"telephone_number": "504-619-8770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VON GRUBEN",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-01",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "LA",
"license": "S-633",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "S-633",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
- Volunteers of America Southeast Louisiana, Inc.
- Volunteers of America Southeast Louisiana, Inc.
- Volunteers of America Southeast Louisiana, Inc.
- Volunteers of America Southeast Louisiana, Inc.
- William Von Almen, MD
- Beatrix Marie Von Koeller Jones, M.D.
- Derek Joseph Vonderhaar, M.D.
- Vonderricks Transportation LLC
- Paul E Voorhies, LCSW
- Kristin Vora, RD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.