NPIMap

Organization Active NPI

W&W Dentistry

  • Dentist
  • Grand Rapids, MI
National Provider Identifier
1003229659
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019234 Issued in MI
Legal business name
W&W DENTISTRY
Practice address
2000 43Rd St SE
Suite C
Grand Rapids, MI 49508-8700
Phone
(616) 455-4108
NPI assigned
Jun 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Authorized official

Name
Dr. Brian A Wiedemer, DDS
Title
Member
Phone
(616) 455-4108

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901019908 MI
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 2901019234 MI Primary

Addresses

Primary practice location

2000 43Rd St SE
Suite C
Grand Rapids, MI 49508-8700

Mailing address

2000 43Rd St SE
Suite C
Grand Rapids, MI 49508-8700
Phone (616) 455-4108

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402358400000",
    "number": "1003229659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 43RD ST SE",
            "address_2": "SUITE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495088700",
            "telephone_number": "616-455-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 43RD ST SE",
            "address_2": "SUITE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495088700",
            "telephone_number": "616-455-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W&W DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A",
        "authorized_official_last_name": "WIEDEMER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "616-455-4108",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019908",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2014; 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.