Roger E Grua, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

135117 Issued in UT

Practice address

3590 Harrison Blvd.
Suite #5
Ogden, UT 84403-2012

Phone

(801) 621-1440

Fax

(801) 394-6833

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

Yes

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": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972620185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 S 1075 E",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844034758",
            "telephone_number": "801-479-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HARRISON BLVD.",
            "address_2": "SUITE #5",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844032012",
            "telephone_number": "801-621-1440",
            "fax_number": "801-394-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUA",
        "first_name": "ROGER",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "135117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Grove, LCSW
• Morgan Grover
• Kathryn Stamos Grow, LCSW
• Richard T Grow, ED D
• Robert W Grow, M.D.
• Cathie M Gruis
• Megan Wolthuis Grunander, MD
• Todd Ryan Grunander, M.D.
• Alexandra Elizabeth Gryder, BCBA
• Guardian Flight LLC

• General Practice Dentistry in Ogden, UT
• Providers in Ogden, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.