Individual provider Active NPI

Alexay Ann Tamas, DMD

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1194178806
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901602689 Issued in MI
Practice address
4345 Sawkaw Dr NE Ste 4
Grand Rapids, MI 49525-6517
Phone
(616) 364-4219
NPI assigned
Jul 18, 2016
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D10651 OR
General Practice Dentistry 1223G0001X 2901602689 MI Primary

Addresses

Primary practice location

4345 Sawkaw Dr NE Ste 4
Grand Rapids, MI 49525-6517

Mailing address

4345 Sawkaw Dr NE Ste 4
Grand Rapids, MI 49525-6517
Phone (616) 364-4219

Other practice location 1

721 Waverly Dr SE
Albany, OR 97322-5080
Phone (541) 928-8434

Other practice location 2

106 S Main St
Vandalia, MO 63382-1806
Phone (573) 594-6166 ext. 46166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901602689MIMDGeneral Practice Dentistry
D10651ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Waverly Dental LLC PastSince Jul 24, 2022 Accepting new patients
Edp of Mi, PC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1194178806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4345 SAWKAW DR NE STE 4",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256517",
            "telephone_number": "616-364-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 SAWKAW DR NE STE 4",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256517",
            "telephone_number": "616-364-4219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 Waverly Dr SE",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973225080",
            "country_code": "US",
            "telephone_number": "541-928-8434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 S Main St",
            "address_purpose": "LOCATION",
            "city": "Vandalia",
            "state": "MO",
            "postal_code": "633821806",
            "country_code": "US",
            "telephone_number": "573-594-6166 x46166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMAS",
        "first_name": "ALEXAY",
        "middle_name": "ANN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D10651",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; 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.