Cornelius Jay Huizinga, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7859 Issued in MI

Practice address

7610 Cottonwood Dr
Suite 108
Jenison, MI 49428-8310

Phone

(616) 457-0620

Fax

(616) 457-1600

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205990405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 COTTONWOOD DR",
            "address_2": "SUITE 108",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288310",
            "telephone_number": "616-457-0620",
            "fax_number": "616-457-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 COTTONWOOD DR",
            "address_2": "SUITE 108",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288310",
            "telephone_number": "616-457-0620",
            "fax_number": "616-457-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUIZINGA",
        "first_name": "CORNELIUS",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "7859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hope Bridge Living LLC
• Alexis Howell
• Patrick Kieran Hughes III, LPC
• Robert C Huizenga, O D
• Chad Huizinga, PHARMD
• Deann Marie Hurn, PHARMACIST
• Chaz Boone Hyatt, PHARMD
• Angela Iacoboni, LLMSW
• Elizabeth Jabour, LMSW
• Chad Walker Jackson

• General Practice Dentistry in Jenison, MI
• Providers in Jenison, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.