Grapevine Denture Service

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08128 Issued in MI

Legal business name

GRAPEVINE DENTURE SERVICE

Practice address

865 US Highway 31 S
Traverse City, MI 49684-8716

Phone

(231) 943-8409

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Jack D Ross, D.D.S.

Title

Dentist

Phone

(231) 943-8409

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902019623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 US HIGHWAY 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848716",
            "telephone_number": "231-943-8409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 US HIGHWAY 31 S",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848716",
            "telephone_number": "231-943-8409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAPEVINE DENTURE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "231-943-8409",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "08128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Traverse Womens Clinic PLLC
• Grandview Dental Associates PLLC
• Grandview Dental Care PLLC
• Kaitlyn Grangood, LMSW, CBIS
• Carrie Lee Grant
• Gwendolyn M Gravelie, MD
• Kathryn A Gray, R.N., F.N.P.
• Natalie A Gray, MD
• Tracey Lynn Gray, M.A., CCC-SLP
• Great Lakes Cardiology, P.C.

• General Practice Dentistry in Traverse City, MI
• Providers in Traverse City, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.