Individual provider Active NPI

Brandon David Grunes, DMD

  • Pediatric Dentistry
  • Natick, MA
National Provider Identifier
1942561253
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DN1856222 Issued in MA
Practice address
230 Pond St
Natick, MA 01760-4323
Phone
(508) 653-2417
NPI assigned
Jun 4, 2012
Last updated
Jul 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN1856222 MA Primary

Addresses

Primary practice location

230 Pond St
Natick, MA 01760-4323

Mailing address

15 Shady Oak LN
Natick, MA 01760-3028
Phone (508) 333-4331

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN1856222MAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Natick Dental Partners LLP Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1942561253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SHADY OAK LN",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017603028",
            "telephone_number": "508-333-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 POND ST",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017604323",
            "telephone_number": "508-653-2417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNES",
        "first_name": "BRANDON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1856222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.