Paul Jay Huizinga, DDS MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2901018332 Issued in MI

Practice address

4330 44TH St SW
Suite 106
Grandville, MI 49418-2349

Phone

(616) 530-4710

Fax

(616) 530-0480

NPI assigned

Aug 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 2, 2024 through Jul 2, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1588614994
  NPD (past)
• Norton Enterprises, Inc.

  • Urgent Care Clinic/Center
  • Louisville, KY
  • NPI 1104863562
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1174516363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 PIUTE DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182474",
            "telephone_number": "616-534-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 44TH ST SW",
            "address_2": "SUITE 106",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182349",
            "telephone_number": "616-530-4710",
            "fax_number": "616-530-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUIZINGA",
        "first_name": "PAUL",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MI",
            "license": "2901018332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4453238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Calvin Howell, DDS
• Kathrin Howerton, LMSW
• Elise Marie Hoxworth, LMSW
• Kelly Morgan Hubbard
• Tiaunna Huddleston
• Hannah Claire Huizingh
• Jonathan Hull, BEHAVIOR TECHNICIAN
• Nicholas Hulsebos Hulsebos
• Human Kind Counseling Group, LLC
• Philip Hunt, OD

• Oral & Maxillofacial Surgery (D.M.D.) in Grandville, MI
• Providers in Grandville, MI by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.