Organization Active NPI

Cedar Springs Dental PLLC

  • Dental Clinic/Center
  • Cedar Springs, MI
National Provider Identifier
1053087536
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
CEDAR SPRINGS DENTAL PLLC
Practice address
20 E Church St
Cedar Springs, MI 49319-7505
Phone
(616) 696-9420
NPI assigned
Aug 17, 2021
Last updated
Aug 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Andres W Setaputri, DDS
Title
Dentist
Phone
(616) 696-9420

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

20 E Church St
Cedar Springs, MI 49319-7505

Mailing address

20 E Church St
Cedar Springs, MI 49319-7505
Phone (616) 696-9420

National Provider Directory

National Provider Directory

Locations

20 E Church St
Cedar Springs, MI 49319
Phone (616) 696-9420

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1053087536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 E CHURCH ST",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493197505",
            "telephone_number": "616-696-9420",
            "fax_number": "616-696-8272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E CHURCH ST",
            "city": "CEDAR SPRINGS",
            "state": "MI",
            "postal_code": "493197505",
            "telephone_number": "616-696-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR SPRINGS DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-17",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "SETAPUTRI",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-696-9420",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Springs, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.