Active NPI
Affinity Dental Care PLC
- Dental Clinic/Center
- Grand Rapids, MI
National Provider Identifier
1194421909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- Legal business name
- AFFINITY DENTAL CARE PLC
- Practice address
- 2807 Lake Michigan Dr NW Ste 3
Grand Rapids, MI 49504-5831 - Phone
- (678) 462-0499
- NPI assigned
- Feb 2, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Manuel R Ale, MBA
- Title
- Office Manager
- Phone
- (404) 207-2605
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Primary |
Addresses
Primary practice location
2807 Lake Michigan Dr NW Ste 3
Grand Rapids, MI 49504-5831
Mailing address
PO Box 141547
Grand Rapids, MI 49514-1547
Phone (404) 207-2605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629497631 | Other | GA | NPPES |
National Provider Directory
National Provider DirectoryLocations
2807 Lake Michigan Dr NW
Ste 3
Grand Rapids, MI 49504
Phone (678) 462-0499
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Public Health Dentistry
- Niles, MI
- NPI 1629497631
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675296000000",
"number": "1194421909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 141547",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495141547",
"telephone_number": "404-207-2605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2807 LAKE MICHIGAN DR NW STE 3",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045831",
"telephone_number": "678-462-0499"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AFFINITY DENTAL CARE PLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A",
"authorized_official_last_name": "ALE",
"authorized_official_first_name": "MANUEL",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "404-207-2605",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES",
"identifier": "1629497631",
"state": "GA"
}
],
"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 Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.