NPIMap

Organization Active NPI

Midwest Implant Surgery Center

  • General Practice Dentistry
  • Jenison, MI
National Provider Identifier
1154800357
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MIDWEST IMPLANT SURGERY CENTER
Practice address
2064 Baldwin St
Jenison, MI 49428-8773
Phone
(616) 457-2299
NPI assigned
Aug 8, 2018
Organization subpart
Yes
Parent organization
MIDWEST FAMILY DENTAL CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Authorized official

Name
Ms. Brandynn Marie Beaver
Title
Admin
Phone
(616) 457-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2064 Baldwin St
Jenison, MI 49428-8773

Mailing address

2064 Baldwin St
Jenison, MI 49428-8773
Phone (616) 457-2299

Other practice location 1

4025 W Main St Ste 102
Kalamazoo, MI 49006-3726
Phone (269) 388-5832

Other practice location 2

2020 Division Ave S
Grand Rapids, MI 49507-3029
Phone (616) 245-2767

National Provider Directory

National Provider Directory
Part of
Midwest Implant Surgery Center

Practitioners & affiliated clinicians

Practitioners 6

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": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533686400000",
    "number": "1154800357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288773",
            "telephone_number": "616-457-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288773",
            "telephone_number": "616-457-2299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4025 W Main St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490063726",
            "country_code": "US",
            "telephone_number": "269-388-5832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2020 Division Ave S",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495073029",
            "country_code": "US",
            "telephone_number": "616-245-2767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST IMPLANT SURGERY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDWEST FAMILY DENTAL CARE",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-08-08",
        "status": "A",
        "authorized_official_last_name": "BEAVER",
        "authorized_official_first_name": "BRANDYNN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "616-457-2299",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2018; 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.