Mattawan Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MATTAWAN FAMILY DENTISTRY

Practice address

56400 City Center Cir
Mattawan, MI 49071-8380

Phone

(269) 568-2609

NPI assigned

Dec 19, 2024

Last updated

Dec 19, 2024By 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. Jonathan Vandenburgh, DDSNPI 1407230212

Title

Owner

Phone

(269) 568-2609

Specialties & licenses 2

Addresses

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.

• Jonathan Vandenburgh, DDS

  • Dentist
  • Mattawan, MI
  • NPI 1407230212
  NPD Authorized official

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1124836531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56400 CITY CENTER CIR",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718380",
            "telephone_number": "269-568-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56400 CITY CENTER CIR",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718380",
            "telephone_number": "269-568-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTAWAN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "VANDENBURGH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "269-568-2609",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shannon L Logsdon, MSPT
• Janine Elizabeth Rigg Loughrin, M.S.W
• Mattawan Chiropractic Clinic, P.C.
• Mattawan Family Eye Care PLC
• Mattawan Pharmacy
• Hailey Maynard
• Robert McDonald, DDS
• Robin Medendorp

• General Practice Dentistry in Mattawan, MI
• Providers in Mattawan, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.