Grant John Ressel, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

2016018916 Issued in MO

Practice address

1 E Broadway
Columbia, MO 65203-4205

Phone

(573) 449-5968

Fax

(573) 449-5149

NPI assigned

Jun 15, 2016

Last updated

Oct 16, 2020By the provider in NPPES

Sex

Male

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

Enrolled in MO

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.

• Ressel Family Dentistry LLC

  dba Bohon and Ressel Family Dentistry

  • Dental Clinic/Center
  • Columbia, MO
  • NPI 1306444740
  NPD Authorized official

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1942650544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034205",
            "telephone_number": "573-449-5968",
            "fax_number": "573-449-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034205",
            "telephone_number": "573-449-5968",
            "fax_number": "573-449-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESSEL",
        "first_name": "GRANT",
        "middle_name": "JOHN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2016018916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renova Medical Center, LLC
• Corey Randall Rentfrow, P.A.-C
• Jennifer Rentschler, RN
• Andrew G Resnik, M.D.
• Ressel Family Dentistry LLC (Bohon and Ressel Family Dentistry)
• Restoration Chiropractic LLC
• Restoration Eyecare LLC (Restoration Eye Care)
• Restore Balance Integrative Wellness
• Retina Associates of Mid Missouri, LLC
• Retina Associates of Missouri, P.C.

• Dentist in Columbia, MO
• Providers in Columbia, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; 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.