Brian M Dolphin, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002301 Issued in MI

Practice address

750 E Beltline Ave NE
Grand Rapids, MI 49525-6049

Phone

(616) 949-2600

Fax

(616) 365-2076

NPI assigned

Jan 28, 2006

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

Other names 1

• Dr. Brian M. Dolphin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1174594105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256049",
            "telephone_number": "616-949-2600",
            "fax_number": "616-365-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256049",
            "telephone_number": "616-949-2600",
            "fax_number": "616-365-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLPHIN",
        "first_name": "BRIAN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00831511",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIAN",
            "last_name": "DOLPHIN",
            "middle_name": "M.",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kayla A Dolce
• Sarah Marie Dolecki, LMSW
• Rhonda Doll, OT
• Molly Frances Dollahan, LMSW
• Stephanie Dolly-McGlothin
• Anitha Reddy Doma, BDS
• James Domagala, LMSW
• Melanie Dombrowski, PT, DPT
• Leahthan Faye Domeshek, MD
• James Mark Domin, D.D.S.

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; 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.