Robert Craig Payne, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10354 Issued in MI

Practice address

1179 E Paris Ave SE
Suite 130
Grand Rapids, MI 49546-3682

Phone

(616) 942-9840

Fax

(616) 942-0170

NPI assigned

Jun 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164462198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 STICKLEY DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466490",
            "telephone_number": "616-949-5185",
            "fax_number": "616-942-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1179 E PARIS AVE SE",
            "address_2": "SUITE 130",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463682",
            "telephone_number": "616-942-9840",
            "fax_number": "616-942-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "ROBERT",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "10354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Ellen Payne, PA
• Eric William Payne, M.D.
• Joseph Conrad Payne
• Kionna Lashaun Payne, LPN
• Natalie Anna Payne, MD
• Thea Pazdernik
• Pca-Corrections LLC (Synchrony Grand Rapids Pharmacy)
• Peace Love Counseling, LLC
• Peaceful Group Home LLC
• Peaceful Homecare LLC

• Pediatric Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.