Robert Dale Renzema

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2901008507 Issued in MI

Legal business name

ROBERT DALE RENZEMA

Practice address

532 Michigan Ave
Holland, MI 49423-4721

Phone

(616) 396-8320

Fax

(616) 396-8764

NPI assigned

Aug 7, 2018

Last updated

Dec 12, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

ROBERT D RENZEMAAs reported in NPPES

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

Authorized official

Name

Robert RenzemaNPI 1093716706

Title

Dentist

Phone

(616) 396-8320

Specialties & licenses 1

Addresses

Part of

Robert Dale Renzema

Locations

Practitioners 2

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.

• Robert D Renzema, DDS

  • Dentist
  • Holland, MI
  • NPI 1093716706
  NPD (past) Authorized official
• David L. Renzema, D.D.S.

  • Dentist
  • Holland, MI
  • NPI 1063411205
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544572800000",
    "number": "1194204636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234721",
            "telephone_number": "616-396-8320",
            "fax_number": "616-396-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234721",
            "telephone_number": "616-396-8320",
            "fax_number": "616-396-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT DALE RENZEMA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROBERT D RENZEMA",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-12-12",
        "status": "A",
        "authorized_official_last_name": "RENZEMA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "616-396-8320"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901008507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Optical, LLC
• Alberto Rivera Gutierrez, MD
• Eva Rivera
• Alexander James Robbins, LPC
• Gerald F Robbins, D.O.
• Jessica Roberts
• Jordyn Alexis Roberts, OTR/L
• Kristi Loraine Roberts, MA, LLPC
• Leslie Barbara Roberts
• Lindsay Kay Roberts, AU.D.

• Dental Clinic/Center in Holland, MI
• Providers in Holland, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.