Organization Active NPI

Tissue Family Dentistry, PLLC

  • General Practice Dentistry
  • Greenville, MI
National Provider Identifier
1043022346
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TISSUE FAMILY DENTISTRY, PLLC
Practice address
112 S Clay St Ste a
Greenville, MI 48838-1999
Phone
(616) 881-2545
NPI assigned
Jan 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Matthew Tissue, DDSNPI 1578910600
Title
Owner/Dentist
Phone
(616) 881-2545

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

112 S Clay St Ste a
Greenville, MI 48838-1999

Mailing address

112 S Clay St Ste a
Greenville, MI 48838-1999
Phone (616) 881-2545

National Provider Directory

National Provider Directory

Locations

112 S Clay St
Ste A
Greenville, MI 48838
Phone (616) 881-2545

Practitioners & affiliated clinicians

Practitioners 1

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": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1043022346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S CLAY ST STE A",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488381999",
            "telephone_number": "616-881-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S CLAY ST STE A",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488381999",
            "telephone_number": "616-881-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TISSUE FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "TISSUE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "616-881-2545",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.