Gina Rae Grenfell, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6892-15 Issued in WI

Practice address

30 N 18TH Ave # 1
Sturgeon Bay, WI 54235-3207

Phone

(920) 743-6976

NPI assigned

Apr 30, 2012

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1942568787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 18TH AVE # 1",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 18TH AVE # 1",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "542353207",
            "telephone_number": "920-743-6976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENFELL",
        "first_name": "GINA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6892-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Gorchynsky, M.D.
• Megan Angela Gorin, DPT
• Gary A Grahl, LPC
• Paul N Greenlaw, M.D.
• Derek Grenfell, D.C.
• Gareth Erwin Gridley, RPH
• Kathryn C Groff, LMFT-IT
• Carl D Grota, PT
• Michael Whitney Grota, PHARMD
• Carol Gale Halvorson, L.P.N.

• Dentist in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.