Moira Gini Groh, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

00202738 Issued in CO

Practice address

2003 46TH Ave
Greeley, CO 80634-3250

Phone

(970) 330-4600

NPI assigned

Apr 11, 2012

Last updated

May 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mod LLC

  dba KidsFirst Dental

  • Dental Clinic/Center
  • Fort Collins, CO
  • NPI 1346679321
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1871850131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 46TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343250",
            "telephone_number": "970-330-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 46TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806343250",
            "telephone_number": "970-330-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROH",
        "first_name": "MOIRA",
        "middle_name": "GINI",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "1572",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "057812",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "00202738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Grim, R.PH
• Clarissa Grissom
• Grit & Grace Nutrition, LLC
• Connor Blair Grogan
• Czarina Grogan
• Henryk Jan Grondalski
• Ingrid Natalia Groover
• La-Shon Groshong, RBT
• Denise Annette Gross, LPN
• Trisha Grossaint

• Pediatric Dentistry in Greeley, CO
• Providers in Greeley, CO by specialty
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.