Martin D Vredenburg DDS PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

MARTIN D VREDENBURG DDS PC

Practice address

1150 N Hudson St
Lowell, MI 49331-1000

Phone

(616) 897-8429

NPI assigned

Aug 25, 2021

Organization subpart

No

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

Authorized official

Name

Martin Vredenburg, DDSNPI 1962482653

Title

President/Owner

Phone

(616) 897-8429

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martin D Vredenburg, D.D.S.

  • General Practice Dentistry
  • Lowell, MI
  • NPI 1962482653
  NPD Authorized official

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1154098374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493310146",
            "telephone_number": "616-897-8429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N HUDSON ST",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493311000",
            "telephone_number": "616-897-8429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN D VREDENBURG DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "VREDENBURG",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "616-897-8429",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Courtney Mace, MSW
• Bethany Mangan, LMSW
• Michael Mankowski
• Maple Ridge Manor of Lowell
• Machaela R Marquez, MT-BC
• Graciana Marie Martin
• Martino Health & Wellness
• Erica Dawn Martino, LPC, CFI, CFTS
• Samantha Rose Massaro
• MBH ABA Therapy PLLC

• All providers in Lowell, MI
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.