Active NPI
Alexay Ann Tamas, DMD
- General Practice Dentistry
- Grand Rapids, MI
National Provider Identifier
1194178806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2901602689
- 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, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2901602689 | MI | MD | General Practice Dentistry |
| D10651 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waverly Dental LLC | Past | 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.
-
- Dental Clinic/Center
- Grand Rapids, MI
- NPI 1811403959
-
- Dentist
- Albany, OR
- NPI 1477979516
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.