Organization Active NPI

W S Grossman DDS Family LTD PTR

  • Dentist
  • Rocky River, OH
National Provider Identifier
1912066366
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13491 Issued in OH
Legal business name
W S GROSSMAN DDS FAMILY LTD PTR
Practice address
2924 Plymouth Ave
Rocky River, OH 44116-3230
Phone
(440) 333-4987
Fax
(440) 333-4986
NPI assigned
Dec 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Walter S Grossman, DDS
Title
General Partner
Phone
(440) 333-4987

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 13491 OH Primary

Addresses

Primary practice location

2924 Plymouth Ave
Rocky River, OH 44116-3230

Mailing address

2924 Plymouth Ave
Rocky River, OH 44116-3230
Phone (440) 333-4987

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912066366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 PLYMOUTH AVE",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163230",
            "telephone_number": "440-333-4987",
            "fax_number": "440-333-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 PLYMOUTH AVE",
            "city": "ROCKY RIVER",
            "state": "OH",
            "postal_code": "441163230",
            "telephone_number": "440-333-4987",
            "fax_number": "440-333-4986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W S GROSSMAN DDS FAMILY LTD PTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSSMAN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "440-333-4987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "13491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky River, OH

Sources for this page

  • 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.