KEITH R. GRONBACH, D.D.S., INC. (NPI# 1093808594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093808594 |
| Entity Type | Organization |
| Organization Name | KEITH R. GRONBACH, D.D.S., INC. |
| Other Organization Name | EAST BAY ORAL SURGERY |
| Practice Address |
3799 Mt Diablo Blvd Lafayette CA 94549-3538 |
| Practice Telephone | 9252834050 |
| Practice Fax Number | 9252835340 |
| Mailing Telephone | 9252834050 |
| Mailing Fax Number | 9252835340 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-07-22 |
| Authorized Official Name | DR. KEITH R. GRONBACH (PRESIDENT) |
| Authorized Official Telephone | 9252834050 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
44317 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| East Bay Oral Surgery | Other Name - Individual/Organization |
| Street Address |
3799 MT DIABLO BLVD |
| City | LAFAYETTE |
| State | CA |
| Zip Code | 94549-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992853204 | Keith Roger Gronbach | Dentist | 3799 Mt Diablo Blvd, Lafayette, CA 94549-3538 | 2007-01-05 |
| 1295825438 | Leonard Mario Saputo | Internal Medicine | 3799 Mt Diablo Blvd, Lafayette, CA 94549-3538 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427004 | Veronica Adelaid Valera-averilla | Behavior Technician | 3650 Mt Diablo Blvd. Ste. 107, Lafayette Ca Contra, CA 94549 | 2020-11-06 |
| 1679128870 | Zong Ning Zhou | Behavior Technician | 3650 Mt.diablo Blvd., Suite 107, Lafayette, CA 94549 | 2019-08-05 |
| 1912551227 | Tamiesha Jackson | Behavior Technician | Ste Consultant, LLC, 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2019-07-25 |
| 1528525375 | Tiara Lajai Aubrey | Behavior Technician | 3560 Mt. Diablo Blvd, Suite 107, Layfatte, CA 94549 | 2019-02-28 |
| 1215409990 | Marisa Della Marmolejo | Case Manager/Care Coordinator | Ste Consultants, LLC 3650 Mt Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-12-19 |
| 1235608399 | Andrew Thompson | Behavior Technician | 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2018-11-19 |
| 1982172953 | Amber Jackson | Behavior Technician | Ste, LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-11-08 |
| 1104393396 | Alexis Taper | Behavior Technician | Ste Consultants LLC, 3650 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-10-26 |
| 1023508793 | Alyssa Savinovich | Behavior Technician | 3560 Mt. Diablo Blvd., Suite 107, Lafayette, CA 94549 | 2018-05-17 |
| 1831689140 | Kannambra M Raja | Behavior Technician | Ste Consultants LLC, 3650 Mt. Diablo Blvd, Suite 107, Lafayette, CA 94549 | 2018-05-11 |
| Find all providers in zip 94549 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1578089603 | Ardoin-kennedy LLC | Dentist | 203 A Energy Parkway, Lafayette, LA 70508 | 2017-08-21 |
| 1154864106 | Coal Creek Oral Surgery and Dental Implant Center, Pllc | Dentist | 1771 Cherokee Trl, Lafayette, CO 80026-7088 | 2016-11-23 |
| 1063629988 | Brett A Henrikson | Dentist | 2 Executive Dr Ste A, Lafayette, IN 47905-4859 | 2007-05-17 |
| 1316169030 | Hiram A. Mcconnell | Dentist | 1231 Coolidge Blvd, Lafayette, LA 70503-2620 | 2007-05-03 |
| 1861523441 | Bruce A Schneider | Dentist | 117 Rue Fontaine, Lafayette, LA 70508-5744 | 2007-03-08 |
| 1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
| 1104920453 | Christian Matthew Steffey | Dentist | 2020 Union St Ste 200, Lafayette, IN 47904-2694 | 2006-09-08 |
| 1780600031 | Mark Alan Welch | Dentist | 200 Republic Ave, I, Lafayette, LA 70508-6826 | 2006-07-13 |
| 1033142872 | Edward A Neupert IIi | Dentist | 3839 W Congress St Ste C, Lafayette, LA 70506-6000 | 2006-07-07 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.