Grigory Rozenvich D.D.S., Inc.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

40115 Issued in CA

Legal business name

GRIGORY ROZENVICH D.D.S., INC.

Practice address

3620 S. Bristol St.
Suite 210
Santa Ana, CA 92704

Phone

(714) 549-1409

Fax

(714) 549-2118

NPI assigned

Oct 23, 2007

Organization subpart

No

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

Authorized official

Name

Grigory Rozenovich

Title

President

Phone

(714) 549-1409

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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

• Vanessa Lynn Bechtol, D.D.S.

  • Dentist
  • Santa Ana, CA
  • NPI 1518142900
  NPD (past)

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1912196171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 S. BRISTOL ST.",
            "address_2": "SUITE 210",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-549-1409",
            "fax_number": "714-549-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 S. BRISTOL ST.",
            "address_2": "SUITE 210",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "92704",
            "telephone_number": "714-549-1409",
            "fax_number": "714-549-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIGORY ROZENVICH D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2015-05-06",
        "status": "A",
        "authorized_official_last_name": "ROZENOVICH",
        "authorized_official_first_name": "GRIGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-549-1409"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CA",
            "license": "40115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "973695",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "7120",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF CA. DENTI-CAL",
            "identifier": "B40115 01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brejoni Yazman-Nyri Griffin
• Cyan Griffin
• Alexanderia Griffith
• Sara Griffith
• Lilian D Griffiths
• Frank Anthony Grimaldi, M.A.
• Heather Kristin Grimaldi, M.S, BCBA
• Maren Grimm, RPA
• Emerson Groom, RADT1
• Gerald Joseph Grosso, PSYD

• Exclusive Provider Organization in Santa Ana, CA
• Providers in Santa Ana, CA by specialty
• Exclusive Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.