Mark R Grenadier, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS025828L Issued in PA

Practice address

4955 Steubenville Pike
#361
Pittsburgh, PA 15205-9619

Phone

(412) 788-9333

Fax

(412) 788-9341

NPI assigned

Nov 16, 2005

Last updated

Aug 2, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Dental Implant Specialists of Pennsylvania I, PC

  dba Montour Oral Surgery

  • Oral and Maxillofacial Pathology Dentistry
  • Pittsburgh, PA
  • NPI 1922829332
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1932181831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 STEUBENVILLE PIKE",
            "address_2": "#361",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152059619",
            "telephone_number": "412-788-9333",
            "fax_number": "412-788-9341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 STEUBENVILLE PIKE",
            "address_2": "#361",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152059619",
            "telephone_number": "412-788-9333",
            "fax_number": "412-788-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENADIER",
        "first_name": "MARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS025828L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Christopher Greim, MD
• Jessica Greiner
• Rachel Christine Greiner, MD
• Christina Marie Gremba
• Jeremy B Grenadier, MD
• Anne Grenci, FNP-C, CRNP
• John H Gresh, PA-C
• Shannon Greskevitch, M.A. CCC-SLP
• Alexis Scarlet Gress
• Kevin Gress, OD

• Oral and Maxillofacial Surgery (Dentist) in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.