Individual provider Active NPI

Caitlin Nicole Grogan, DMD

  • Dentist
  • La Mesa, CA
National Provider Identifier
1962183988
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109018 Issued in CA
Practice address
5308 Lake Murray Blvd Ste E
La Mesa, CA 91942-1334
Phone
(619) 469-4144
NPI assigned
Jul 31, 2023
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109018 CA Primary

Addresses

Primary practice location

5308 Lake Murray Blvd Ste E
La Mesa, CA 91942-1334

Mailing address

969 Market St Unit 1601
San Diego, CA 92101-7291
Phone (202) 412-5287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231023000753 CA Order and Referring Only - DentistPractitioner - Dentist 5597111963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy Shen, DDS, Inc. CurrentSince Oct 12, 2025 Accepting new patients
Cheryl Tran DDS Inc. PastSince Aug 1, 2023 Accepting new patients

Locations

5308 Lake Murray Blvd
Ste E
La Mesa, CA 91942
Phone (619) 469-4144

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": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1962183988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "969 MARKET ST UNIT 1601",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017291",
            "telephone_number": "202-412-5287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 LAKE MURRAY BLVD STE E",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421334",
            "telephone_number": "619-469-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN",
        "first_name": "CAITLIN",
        "middle_name": "NICOLE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

Verify at the official NPI Registry.