Organization Active NPI

Affinity Dental Care PLC

  • Dental Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1194421909
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
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

Updated by the provider on Feb 2, 2023

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1629497631OtherGANPPES

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.