NPIMap

Organization Active NPI

Schaefer Dental Group - Grand Rapids, PLLC

  • General Practice Dentistry
  • Jenison, MI
National Provider Identifier
1174333991
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SCHAEFER DENTAL GROUP - GRAND RAPIDS, PLLC
Practice address
657 Baldwin St
Jenison, MI 49428-7903
Phone
(616) 532-3212
Fax
(616) 532-3193
NPI assigned
Jan 13, 2025
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Dr. Brian Patrick Schaefer, DDSNPI 1255425047
Title
Owner
Phone
(517) 896-0039

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

657 Baldwin St
Jenison, MI 49428-7903

Mailing address

4911 W St Joe Hwy
Lansing, MI 48917-4088
Phone (517) 321-1848

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1736726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1174333991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 W ST JOE HWY",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174088",
            "telephone_number": "517-321-1848",
            "fax_number": "517-321-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494287903",
            "telephone_number": "616-532-3212",
            "fax_number": "616-532-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHAEFER DENTAL GROUP - GRAND RAPIDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "SCHAEFER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-896-0039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "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 Jan 13, 2025; 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.