Ouderkirk Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OUDERKIRK DENTAL PLLC

Practice address

11970 Sweetwater Dr
Grand Ledge, MI 48837-8199

Phone

(517) 627-2470

NPI assigned

Nov 19, 2021

Organization subpart

No

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

Authorized official

Name

Evan Ouderkirk, DDSNPI 1790308492

Title

Member

Phone

(517) 917-1836

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Evan David Ouderkirk, DDS

  • General Practice Dentistry
  • Grand Ledge, MI
  • NPI 1790308492
  NPD Authorized official
• Scott Thomas Stevenson, D.D.S.

  • Dentist
  • Grand Ledge, MI
  • NPI 1891746715
  NPD (past)

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1003573403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 GRENOBLE CIR",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174811",
            "telephone_number": "517-917-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11970 SWEETWATER DR",
            "city": "GRAND LEDGE",
            "state": "MI",
            "postal_code": "488378199",
            "telephone_number": "517-627-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUDERKIRK DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "OUDERKIRK",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "517-917-1836",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Anthony Mulder, DDS
• Cynthia Denise Munro, NP
• Quan D Nguyen, MD
• Nancy Novakoski, OTR
• Orthodontic Specialists of Mid-Michigan, PC
• Evan David Ouderkirk, DDS
• Elizabeth Paine, D.O
• Erin Parcell, LPC
• Mindy Parshall
• Teresa L Patterson, LMSW

• General Practice Dentistry in Grand Ledge, MI
• Providers in Grand Ledge, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.