Individual provider Active NPI

Seth Adam Vruggink, DDS

  • General Practice Dentistry
  • Grand Haven, MI
National Provider Identifier
1013035245
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901018162 Issued in MI
Practice address
522 S Beacon Blvd
Grand Haven, MI 49417-1954
Phone
(616) 846-3230
Fax
(616) 846-6156
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901018162 MI Primary

Addresses

Primary practice location

522 S Beacon Blvd
Grand Haven, MI 49417-1954

Mailing address

15450 Oak Dr
Spring Lake, MI 49456-2148
Phone (616) 847-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160114002561 MI Order and Referring Only - DentistPractitioner - Dentist 4183927734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901018162MIMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013035245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15450 OAK DR",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494562148",
            "telephone_number": "616-847-4044",
            "fax_number": "616-846-6156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 S BEACON BLVD",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171954",
            "telephone_number": "616-846-3230",
            "fax_number": "616-846-6156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VRUGGINK",
        "first_name": "SETH",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901018162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

Verify at the official NPI Registry.