NPIMap

Organization Active NPI

Byron Center Family Dental PLLC

  • General Practice Dentistry
  • Wyoming, MI
National Provider Identifier
1013363761
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18853 Issued in MI
Legal business name
BYRON CENTER FAMILY DENTAL PLLC
Practice address
4489 Byron Center Ave SW
Suite a
Wyoming, MI 49519-4804
Phone
(616) 534-8554
Fax
(616) 534-8063
NPI assigned
May 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Authorized official

Name
Denise Hendrie
Title
Office Manager
Phone
(231) 865-6945

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 18853 MI Primary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 29010020645 MI
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 5315070576 MI

Addresses

Primary practice location

4489 Byron Center Ave SW
Suite a
Wyoming, MI 49519-4804

Mailing address

4489 Byron Center Ave SW
Suite a
Wyoming, MI 49519-4804
Phone (616) 534-8554

National Provider Directory

National Provider Directory

Locations

4489 Byron Center Ave SW
Ste A
Wyoming, MI 49519
Phone (616) 534-8554

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": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1013363761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4489 BYRON CENTER AVE SW",
            "address_2": "SUITE A",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194804",
            "telephone_number": "616-534-8554",
            "fax_number": "616-534-8063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4489 BYRON CENTER AVE SW",
            "address_2": "SUITE A",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194804",
            "telephone_number": "616-534-8554",
            "fax_number": "616-534-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BYRON CENTER FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "HENDRIE",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-865-6945"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "18853",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "29010020645",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "5315070576",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.