Active NPI
Jenny Adina Grunberg, DMD
- General Practice Dentistry
- Paw Paw, MI
National Provider Identifier
1942401047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11442
- Practice address
- 54055 County Rd 653
Paw Paw, MI 49079 - Phone
- (269) 657-3900
- Fax
- (269) 657-4530
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11442 | MI | Primary |
Addresses
Primary practice location
54055 County Rd 653
Paw Paw, MI 49079
Mailing address
8814 W H Ave
Kalamazoo, MI 49009-8505
Phone (269) 375-4489
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11442 | MI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joseph Dental Group | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Paw Paw, MI
- NPI 1124970678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942401047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8814 W H AVE",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490098505",
"telephone_number": "269-375-4489",
"fax_number": "269-657-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54055 COUNTY RD 653",
"city": "PAW PAW",
"state": "MI",
"postal_code": "49079",
"telephone_number": "269-657-3900",
"fax_number": "269-657-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUNBERG",
"first_name": "JENNY",
"middle_name": "ADINA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "11442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paw Paw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.