Active NPI
Jessica Gruber, DDS
- Dentist
- Glendale, WI
National Provider Identifier
1992320196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1002312
- Practice address
- 7155 N Port Washington Rd
Glendale, WI 53217-3841 - Phone
- (414) 928-2518
- NPI assigned
- Jun 12, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 1002312 | WI | Primary |
Addresses
Primary practice location
7155 N Port Washington Rd
Glendale, WI 53217-3841
Mailing address
7155 N Port Washington Rd
Glendale, WI 53217-3841
Phone (414) 928-2518
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1002312 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668038400000",
"number": "1992320196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7155 N PORT WASHINGTON RD",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532173841",
"telephone_number": "414-928-2518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7155 N PORT WASHINGTON RD",
"city": "GLENDALE",
"state": "WI",
"postal_code": "532173841",
"telephone_number": "414-928-2518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBER",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-12",
"last_updated": "2022-11-10",
"certification_date": "2022-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "1002312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.