Pediatric Dental Specialists of West Michigan

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PEDIATRIC DENTAL SPECIALISTS OF WEST MICHIGAN

Practice address

2155 E Paris Ave SE Ste 120
Grand Rapids, MI 49546-6142

Phone

(616) 608-8898

NPI assigned

Nov 29, 2018

Last updated

Nov 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kathryn L SwansonNPI 1053726422

Title

Pediatric Dentist

Phone

(248) 705-3285

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Kathryn Lynn Swanson, D.D.S.

  • Pediatric Dentistry
  • Hudsonville, MI
  • NPI 1053726422
  NPD (past) Authorized official

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1184194433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 CROSWELL AVE SE",
            "city": "EAST GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063005",
            "telephone_number": "248-705-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E PARIS AVE SE STE 120",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466142",
            "telephone_number": "616-608-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL SPECIALISTS OF WEST MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "248-705-3285",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis M Peck, R.D
• Scott Peckham
• Ashley Pecott
• Abbigal Louise Pecynski
• Maya Pedersen, PHARMD
• Pediatric Dentistry of Michigan PLLC
• Pediatric Ophthalmology PC
• Pediatric Psychologists of West Michigan, PLC
• Pediatric Speech Services LLC
• Pediatric Surgeons of West Michigan PC

• 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 Nov 29, 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.