Individual provider Active NPI

Michael Joseph Groover

  • General Practice Dentistry
  • Savannah, GA
National Provider Identifier
1942595715
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DNO14277 Issued in GA
Practice address
711 E 70TH St
Suite B
Savannah, GA 31405-4829
Phone
(912) 354-9541
Fax
(912) 354-3950
NPI assigned
Jun 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DNO14277 GA Primary

Addresses

Primary practice location

711 E 70TH St
Suite B
Savannah, GA 31405-4829

Mailing address

711 E 70TH St
Suite B
Savannah, GA 31405-4829
Phone (912) 354-9541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20150611001590 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0446571780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DNO14277GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1942595715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 E 70TH ST",
            "address_2": "SUITE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054829",
            "telephone_number": "912-354-9541",
            "fax_number": "912-354-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 E 70TH ST",
            "address_2": "SUITE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054829",
            "telephone_number": "912-354-9541",
            "fax_number": "912-354-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOVER",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-09",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DNO14277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.