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Active NPI 1487736112 Individual Practitioner Male Practitioner

Dr. Derek P Grzanich , DDS

Dentist - Endodontics • Peoria, IL

Professional Overview & Biography Verified Profile Summary

Dr. Derek Grzanich, DDS is a registered healthcare professional specializing in Dentist - Endodontics in Peoria, IL. Practice services are available at 9016 N ALLEN RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9016 N Allen Rd
Suite B

Peoria, IL 616151513

Telephone 3096904500
Fax 3096904500
Associated Practice Facility / Clinic
🏢 Associates In Dentistry Facility NPI 1538241278

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Endodontics in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
7 Specialists

Practicing in Peoria, IL (222 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-09-12
Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

State License TX 29339

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Dentist - General Practice

NUCC Taxonomy Code: 1223G0001X

State License IL 019026724

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
NPI 1497364517

Doctor of Dental Medicine

Dr. Steven Mahany , DMD

Dentist - General Practice

NPI 1619059268

Doctor of Dental Medicine

Dr. Kelly Abrams , DDS

Dentist - General Practice

NPI 1730261470

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active June 15, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location June 15, 2012

Registered at 9016 N ALLEN RD, SUITE B, PEORIA, IL 616151513 (Tel: 3096904500)

📍
Updated Business Mailing Address June 15, 2012

Registered at 5518 W BROOKMERE DRIVE, EDWARDS, IL 615289407 (Tel: 3096832877)

👤
Provider Name / Credentials Updated June 15, 2012

Recorded as DEREK GRZANICH, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2012

Dentist (License #019026724 in IL)

🟢
Initial NPI Registration & Enumeration October 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487736112
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 20, 2006
Last Update: September 12, 2025
Sole Proprietor: No

Mailing Address

5518 W Brookmere Drive

Edwards, IL 615289407

Phone: 3096832877

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.