Active NPI
Thomas Edward Herremans, DDS MPH MS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Grand Rapids, MI
National Provider Identifier
1205996121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 2901017050
- Practice address
- 4353 Sawkaw NE
Grand Rapids, MI 49525 - Phone
- (616) 363-9821
- Fax
- (616) 365-9206
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2901017050 | MI | Primary |
Addresses
Primary practice location
4353 Sawkaw NE
Grand Rapids, MI 49525
Mailing address
4353 Sawkaw NE
Grand Rapids, MI 49525
Phone (616) 363-9821
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2166835 | Medicaid | MI |
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 |
|---|---|---|---|
| 2901017050 | MI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205996121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4353 SAWKAW NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49525",
"telephone_number": "616-363-9821",
"fax_number": "616-365-9206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4353 SAWKAW NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49525",
"telephone_number": "616-363-9821",
"fax_number": "616-365-9206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERREMANS",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "DDS MPH MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MI",
"license": "2901017050",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2166835",
"state": "MI"
}
],
"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 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.