Douglas a Bleyenburg DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

16773 Issued in MI

Legal business name

DOUGLAS A BLEYENBURG DDS PC

Practice address

170 College Ave
#220
Holland, MI 49423

Phone

(616) 392-2302

Fax

(616) 392-9060

NPI assigned

Aug 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas A Bleyenburg, DDSNPI 1811140973

Title

President

Phone

(616) 392-2302

Specialties & licenses 1

Addresses

Other names 1

• Dental Office Other name

Locations

Practitioners 1

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.

• Douglas A Bleyenburg, DDS

  • Dentist
  • Holland, MI
  • NPI 1811140973
  NPD (past) Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083624662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 COLLEGE AVE",
            "address_2": "#220",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-392-2302",
            "fax_number": "616-392-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COLLEGE AVE",
            "address_2": "#220",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "49423",
            "telephone_number": "616-392-2302",
            "fax_number": "616-392-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS A BLEYENBURG DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLEYENBURG",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-392-2302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "16773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lydia Dominguez
• Charles D Donaldson, LLP, LPC
• Megan L Donnelly
• McKinsey Doolaard
• Vanessa Doty, NP-C
• Chloe Rose Douglas
• Kristin Douma, LMSW
• Downtown Optical Shoppe, Inc.
• Lynne Marie Doyle, MA, LLP
• Allison Beth Dozeman, DPM

• Dentist in Holland, MI
• Providers in Holland, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.